Having a heart attack during sex is one of those tropes that always seems to happen in movies, but never really seems that realistic in real life. Sex isn’t that intense of a workout, although you can burn plenty of calories during sex.

But mid-coitus heart attacks do happen. For one in 100 men, sex can turn fatal and trigger a heart attack, according to a study published in the Journal of the American College of Cardiology. In the study, researchers looked at the health reports of 4,500 people who experienced sudden cardiac arrest. While the numbers are slim (less than 1% of people die immediately after sex), 94% of sex-related heart attacks happen in men, researchers found.

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We’re not talking about ancient dudes whose hearts couldn’t handle the little blue pill, but age is a factor: Men who suffer sudden cardiac arrest during sex tend to be around 60 years old, and they’re likely to have a heart condition or currently be taking heart medication.

Bottom line: Take care of your ticker. Check out these five tips for taking care of your heart.