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Older men who have sex at least once a week may have a higher risk of suffering cardiovascular events than those who are sexually inactive, according to a new study.

The study’s findings, gathered from 2,204 participants of the National Social Life, Health and Aging Project between ages 57 and 86, show that older men who had sex at least once a week had nearly two times greater risk of cardiovascular events such as heart attacks or stroke over 5 years than men who were not sexually active.

That risk increased even more in older men who found sex extremely satisfying or pleasurable. The increased risk may be due to testosterone levels and medications or supplements older men may take to improve sexual function, researchers noted.

On the opposite end of the spectrum, the study found that “quality” or pleasurable sexual activity may help lower the risk of hypertension for older women.

The study’s Michigan State University-based authors said they hope the results inspire physicians to talk with older patients about the potential dangers of strenuous sexual activity, especially in men with existing cardiovascular risks.

Results of the study were published this week in the Journal of Health and Social Behavior.