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Warning, couch potatoes: Sudden physical exertion – even sex – may trigger a heart attack in people who exercise seldom, if ever.

Two researchers at Tufts Medical Center in Boston – Issa Dahabreh and Jessica Paulus – examined 14 studies that investigated the links between physical activity, sex and heart attacks.

Although regular exercise leads to a stronger heart and better overall health, an unusual burst of activity could prove hazardous for the unfit, the duo's finding's, published in the Journal of the American Medical Association, confirm.

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"Individuals who engage in sexual activity have a 2.7-fold increase in the risk of heart attack during a brief window of time – on the order of several hours – during and after the sexual activity, as compared to periods of time when the person is not having sex," Dr. Paulus said in an e-mail.

Still, these figures need to be put into context. "The risk is only increased for a short period of time. This means that these 'triggers' have a relatively small impact on an individual's risk of heart attack over a long period of time," she explained.

So the number of cases would be relatively small. "If 10,000 people engaged in one or more episodes of physical or sexual activity per week, that would potentially trigger only 1 to 2 additional cases of heart attack or sudden cardiac death over the course of a year in that group."

The researchers certainly don't want to scare people away from exercise – or sex – with their findings. In fact, you're going to have "safer sex" – at least in terms of heart health – if you are physically active on a regular basis.

The main message of this study is that people who are unaccustomed to exertion should "increase their physical activity very gradually," said Dr. Paulus. She added they "would be well advised to develop an exercise program under the care and supervision of a physician."

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