A new study by the University of Florence indicates that “sudden coital death” is more common when a man is engaging in extramarital sex in an unfamiliar setting than when he’s having sex with his spouse at home, the Daily Mail reported Tuesday.

The researchers found that infidelity outside the home was associated with “a higher risk of major cardiovascular event,” including fatal heart attacks. Heart attacks were less common when a man was having sex with his wife in a familiar setting.

Though they weren’t able to pinpoint a precise reason for the correlation, the researchers offered some possible explanations, including a guilty conscience, stress related to keeping the affair under wraps and keeping up with the demands of a younger lover.

“Extra-martial sex may be hazardous and stressful because the lover is often younger than the primary partner and probably sex occurs more often following excessive drinking and/or eating,” researcher Dr. Alessandra Fisher told the Daily Mail. “It is possible that a secret sexual encounter in an unfamiliar setting may significantly increase blood pressure and heart rate, leading to increased oxygen demand.”

It’s not the first time infidelity has been linked to heart failure. In January 2012 study, the Centers for Disease Control and Prevention analyzed autopsy reports of 5,559 people who died abruptly from heart complications and found that 75 percent of those who died during sex were engaging in extramarital sex or cheating on their spouce.

And in 2009, Italian researchers found that men in longterm extramarital relationships were more likely to experience a serious heart event than other men.

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