Sexual activity is safe for most patients with stable cardiovascular disease as long as they can also handle other moderate physical activities without symptoms, according a statement from the American Heart Association released on Thursday.

However the association recommended that patients diagnosed with cardiovascular disease to get a comprehensive check-up from their doctor before resuming sexual activity, and patients with unstable disease or severe symptoms should first be stabilized before having sex.

Experts reviewed data on sexual activity and heart diseases "in order to provide recommendations and foster physician and other healthcare professional communication with patients about sexual activity," according to the statement.

Researchers in previous studies who examined young married men compared sexual activity with a usual partner to be roughly equal to mild to moderate physical activity like climbing two flights of stairs or walking at a quick pace.

The researchers noted that the comparison might not apply to older adults or to patients with cardiovascular problems because these individuals may have to exert themselves more than their healthier counterparts.

The authors provided other recommendations for cardiovascular patients who wish to engage in sexual activity:

-Cardiovascular patients who were women should receive counseling and safety advice on pregnancy and various types of contraception when appropriate.

-Heart patients should first undergo a physical examination and provide a detailed medical history before starting or resuming sexual activity.

-Sexual activity can be safety engaged for patients who have a low risk of complications following a clinical evaluation.

-Exercise stress testing should be efficient in evaluating exercise capacity and the development of symptoms, ischemia, or arrhythmias for patients who do not know their cardiovascular risk.

-Sexual activity is safe for patients who exercise with mild to moderate intensity without complications like angina, excessive dyspnea, ischemic ST-segment changes, cyanosis, hypotension, or arrhythmia.

-Cardiac rehabilitation and regular exercise can reduce risks associated with sexual activity-related cardiovascular complications for patients.

-Patients who develop cardiovascular symptoms while having sex should not have sex until their condition is stabilized and optimally managed.

Researchers said that although cardiovascular medications rarely cause sexual dysfunction, some diuretics and beta-blockers have been associated with erectile dysfunction.

Health experts said that concerns for erectile dysfunction should not discourage patients from taking medications for needed to treat cardiovascular symptoms, and also drugs like Viagra, Levitra and Cialis for treating erectile dysfunction are suitable for male patients with stable cardiovascular disease, the safety is still unknown.

Researchers also noted that postmenopausal women with heart disease could use local or topical estrogen to treat painful intercourse.

"When possible, pharmacotherapy, device and surgical intervention, registries, and longitudinal studies of patients with cardiovascular disease should specifically include data on sexual activity and function," researchers wrote.

"Future studies of interventions to improve sexual activity in the context of cardiovascular disease, including sexual counseling, should address sexual concerns and activity of both men and women, young and old, and both patients and partners," researchers concluded.

“Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners,” said Glenn Levine, lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston in a statement. “Unfortunately, discussions about sexual activity rarely take place in the clinical context.”

The statement is published online in Circulation: Journal of the American Heart Association.