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In addition, routine hospital activity data and relevant clinical and pathological reports were abstracted from hospital notes for all men suspected of suffering a stroke.
General practitioner records were inspected for events that had not led to hospital admission.
Of 2818 men identified 2513 (89%) participated in the baseline survey—Phase I—in 1979–83.
At recruitment a clinic assessment including a standard medical history, together with a wide range of variables including weight, height, blood pressure, and a 12 lead ECG.
Recall of sexual intercourse has been shown to be a reliable measure of male sexual activity, correlating with plasma testosterone and other gonadotrophins, and showing an age related decline in a study of 220 men aged 41 to 93 years.
The question was asked only in the first period of the survey and was abandoned because of concerns about affecting the overall response rate.
Conclusions: The differential relation between frequency of sexual intercourse, stroke and coronary heart disease suggests that confounding is an unlikely explanation for the observed association with fatal coronary heart disease events.
As strokes occur quite commonly at night and in the early morning, coincidence with sexual activity may result in survivors and their partners assuming a causal association.