Sex might seem like a risky occupation for the more than 27 million Americans who have been diagnosed with heart disease. But that's not necessarily so, says a new report. The risk varies greatly depending on the severity of a person's condition—as well as how stressful (or, perhaps, exciting) the sex is.

Cardiac patients whose condition is considered stable have a low risk of inducing further heart problems by having sex, according to the report, published online Thursday in Circulation: Journal of the American Heart Association. Of all people who die suddenly, only about 0.6 percent did so while engaging in sexual activity, according to previous research. If that still sounds a little risky, consider that three quarters of those people were sleeping with someone other than their spouse—most with a younger partner, at a location other than home, or were trying to perform "after excessive food and alcohol consumption," says report authors, led by Glen Levine, of the Baylor College of Medicine.

The researchers suggest that relatively healthy heart disease sufferers might do well to stress less about sex—and checking with their doctor is a good first step toward ensuring that it's a safe endeavor. "Changes in sexual activity after a cardiac event may impair the patient's quality of life, negatively affect psychological health, and strain marital or other important intimate relationships, which in turn may lead to depression and anxiety," according to the report. Research published last year found that sexual satisfaction might actually help protect against heart disease.

The report also concludes that cardiovascular drugs have minimal effect on sexual function, and the authors recommend patients continue to take their meds. They also advise talking these things over with a doctor of counselor. Most patients and their partners feel that "they have been inadequately educated on this topic by healthcare providers and desire more information on how to resume their normal sexual activity," the authors noted.