Middle-aged adults with recently diagnosed heart disease may be less sexually active than their healthier peers, a recent U.K. study suggests.

Researchers analyzed survey data from about 3,000 men and 3,700 women aged 50 and older, including 376 men and 279 women with heart disease.

Among heart disease patients diagnosed less than four years before the survey, both men and women were much less likely to report having any sex in the past year than their counterparts without heart problems.

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"We cannot say for certain what the causes of these differences in sexual activity are," said lead study author Andrew Steptoe, of the British Heart Foundation and University College London.

"My suspicion is that it is a mixture of caution and nervousness on the part of patients and their partners, reinforced in some cases by medical advice to take things slowly," Steptoe said by email.

Overall, about 79 percent of men and 55 percent of women in the study said they were sexually active, Steptoe and colleagues report in the journal Heart.

Men with heart disease diagnosed in the past four years were 76 percent less likely to have had sex in the past year than men without heart problems. Women diagnosed within this time frame were 56 percent less likely to say they were sexually active in the past year than women without heart disease.

The people with heart disease were significantly older than the other participants. They were also less likely to be married or living with a partner.

Among those diagnosed within the last four years, men were 45 percent less likely to report thinking about sex at least twice in the past month than their peers without heart trouble. Women were also less likely to think about sex this often, but the results for women with heart disease were too similar to those from other women to rule out the possibility that differences were due to chance.

Recently diagnosed men were also more than twice as likely as men without heart disease to report erectile difficulties, the study found.

Medication may explain this for some men in the study.

Men prescribed diuretics to help them urinate or statins to lower cholesterol were much more likely to report erectile dysfunction.

The study wasn't designed to prove that heart disease causes erectile difficulties or other sexual health problems, the authors note. For many survey questions, there also wasn't a big enough difference between people with and without heart disease for the results to be statistically meaningful.

Even so, the findings suggest that doctors may want to talk to heart disease patients about resuming sexual activity after their diagnosis, the authors conclude.

It's possible that at least some of the reduced sexual activity reported by people with heart disease in the study was because they were older than the participants without this diagnosis, noted Elaine Steinke, a researcher at Wichita State University in Kansas who wasn't involved in the study.

Heart disease patients may also express concerns about sexual activity if they have recently experienced symptoms such as chest pains or shortness of breath and have anxiety or fear about sex, Steinke said by email.

Some patients are afraid that engaging in sex may be too much for their heart, Steinke said. "This is particularly true for those who have had a heart attack," she added. "Reassuring patients that being concerned about sexual activity is normal, and (advising them to ease) back into sexual activity, can allay their fears."