Sarah Evans, Manager of AXA PPP healthcare's Dedicated Heart Nurse Service, Rita Makri, Dietician and Jemelle Carpenter-Gayle, Physiologist

Improve your circulation through exercise

10 March 2020

British Heart Foundation statistics show cardiovascular or circulatory disease remains the UK’s biggest killer, causing over a quarter (27%) of all deaths in the UK each year, the majority of which are due to coronary heart disease and stroke. This adds up to nearly 170,000 people a year, or 460 a day, dying from heart and circulatory diseases. Of these, 44,000 (or 120 a day) are under 75. So, while it’s true that as you get older, your risk of CVD increases, it’s important to start looking after your heart and circulatory health, whatever your age.

The good news is that there are ways you can help protect yourself, for the immediate future and the longer term and one of the best is to increase your physical activity levels. 

Lack of activity is one of the biggest causes of poor circulation,1 so simply adding some gentle exercise to your daily routine is a good place to start to maintain good circulation.

The Chief Medical Officer’s physical activity guidelines for good health recommend adults should aim to be active daily, with at least 150 minutes of moderate intensity exercise, or 75 minutes of intense exercise (or a combination of both), plus two sessions of strength exercises each week.2 

According to the latest guidance, meeting the recommended levels of physical activity can reduce your risk of coronary heart disease by 35%.3

In this article, Sarah Evans, Registered nurse and manager of AXA PPP healthcare’s Dedicated Heart Nurse service, together with Nutritionist Rita Makri and Physiologist Jemelle Carpenter-Gayle, look at circulation issues, why exercise helps, and which activities are best when it comes to boosting your circulation and heart health.

Understanding circulation and your cardiovascular system

The circulatory system, otherwise known as your cardiovascular system, plays an important role in the effective functioning of your body. Made up of your heart, blood and blood vessels, it’s how oxygen and nutrients are transported through arteries to the cells in your body and waste products, such as carbon dioxide, are carried away from the cells in your veins. 

The term cardiovascular disease is used to describe all diseases affecting your circulation or heart. These include heart disease, stroke, angina, heart failure and vascular dementia.

A major risk factor for many of these diseases is atherosclerosis – furring up of your arteries – caused by fatty substances, such as cholesterol.

“If your arteries become ‘furred up’, your blood supply becomes less efficient. In some cases, it can become completely blocked. The most common cause is atherosclerosis, where ‘plaques’ filled with fatty substances, such as cholesterol, are laid down on the inside of your arteries, like limescale in pipes in your home,” explains Sarah.

Atherosclerosis causes arteries to harden and narrow, which can restrict blood flow and affect the function of key organs. Also, if a plaque ruptures and part of it breaks away, it can cause a potentially fatal blood clot.

Health effects of poor circulation

If you have poor circulation, the supply of oxygen and nutrients to the affected arteries is reduced.

This can result in various symptoms, depending on which part of your body is affected.

If your heart arteries are narrowed, you’re likely to have chest pain, or angina, when you exert yourself. Your risk of a heart attack also increases.

If your leg arteries are affected (peripheral vascular disease or PVD), you’re likely to have pain in your legs when you walk. The pain is usually in your calves, often felt after walking a specific distance. With time it tends to get more severe and can occur when resting.

Peripheral vascular disease can increase your risk of leg ulcers and, in severe cases, toe or foot amputation.

Cold feet can also be a consequence of poor circulation, but there are a number of causes. They include anaemia, diabetes mellitus, underactive thyroid, as well as circulatory problems, so it’s important to get checked out. 

If you experience any of the symptoms described above, you should visit your GP for a firm diagnosis and to discuss next steps if appropriate.

How exercise helps boost circulatory health at any age

“Exercise helps circulation as it increases blood flow, gets the heart pumping blood around your body faster and helps flush the blood through your arteries,” explains Physiologist Jemelle. “And it’s never too early or too late to start proactively looking after your cardiovascular health.”

We know that in younger people, regular exercise causes certain changes in the heart, including lowering resting heart rate and increasing the amount of blood pumped with each heartbeat, which make the heart a better pump and can help prevent against heart disease in later life. 

Evidence also suggests that people who begin exercise training in later life, for instance in their 60s and 70s, can also experience improved heart function and reduce their risk of a coronary event, like a heart attack. And that the higher the intensity the more the risk is reduced.4 That said, it’s important not to jump straight in at the deep end…

“If you haven’t exercised for a long time, it’s important to build it up gradually to avoid putting your heart under undue stress,” cautions Jamelle. “And if you have conditions such as a history of heart attack, angina or PVD, it’s important to consult your healthcare professional before embarking on a new exercise regime.”

Exercises to improve circulation 

The best activity to improve circulation is aerobic exercise – the kind that makes you mildly out of breath. This includes jogging, swimming, cycling, dancing, rowing, boxing, team sports, aerobic or cardio classes, or brisk walking. 

Walking – probably one of the easiest ways to boost your circulation is to go for a brisk walk. It’s free, requires no special equipment, you can do it (pretty much) anywhere. It’s also easy to fit into your usual routine, even for those whose opportunity to increase activity levels, especially during the week, is limited by long hours and sedentary working. If that’s you, try incorporating walking into your commute or go for a walk at lunchtime. Just 30 minutes, 5 days a week is what it takes to meet the recommended aerobic activity guidelines, so by the time you get home on Friday, that’s the job done  (though don’t forget you still need to do some strength exercises as well). Plus you get all the added benefits that being out and about offer, from topping up your vitamin D levels to improved self-esteem. See our article for more on the health benefits of exercising outdoors.

Jogging is another great option because it not only gets your heart rate pumping and blood flowing round your body, but can also help build cardio endurance. According to a recent study in the Journal of the American College of Cardiology, even running at slow speed for just five to 10 minutes a day is associated with a dramatically reduced risk of dying form cardiovascular disease.5 Plus it’s as freely accessible as walking, though you should invest in a good pair of running shoes. As well as boosting circulation, running has a whole bunch of additional benefits, from building bone health to managing depression and improving self-esteem, not to mention the high that comes from the release of powerful feel-good chemicals, endorphins, when you run. If you’re new to jogging, start small and build up gradually to give yourself a chance to get the bug! Try alternating between jogging and brisk walking and don’t forget to add some stretches to the beginning and end of your routine. Follow these tips and you’ll be far more likely to go back for more.

If the thought of running leaves you cold, or you’re unable to participate in other forms of exercise because of pain, illness, injury or if you’re in the latter stages of pregnancy, swimming is a great low-impact option, delivering similar benefits, without putting pressure on your joints in the same way as going for a run would. And it’s great for your cardiovascular health. In a study of 80,000 people, commissioned by Swim England, swimmers were found to 41% lower risk of death due to heart disease and stroke.6 Plus, swimming has additional benefits over and above other forms of exercise. For instance, it’s suitable for all shapes, sizes, ages, abilities and fitness levels; the water resistance adds an element of strength training to your aerobic workout as well as increasing calories burned; and because it hurts less you can usually keep going for longer. When it comes to getting bang for your buck from your exercise regime, swimming is hard to beat, so dive in and start reaping the benefits right away.

Remember, not all exercise looks or feels like exercise. Gardening, for example, is an activity people from every walk of life enjoy as a hobby, that’s also really good for many aspects of your physical and mental health. Not only does it provide both aerobic and strength exercise, together with the multiple health benefits of being both outdoors and being surrounded by greenery, you end up with a beautiful space to relax in and enjoy, or a ready supply of fresh vegetables, or both! 

Dancing’s another activity that’s great fun as well as being a fabulous way to boost your circulatory health, and you can do it whenever and – within reason - wherever you like. Just put on your favourite track and give it all you’ve got!  If you prefer to groove along with others, there are plenty of options to try - look out for local classes, like Zumba, salsa, ballroom, or even belly dancing. Otherwise just turn up the volume at home and get on down for the ultimate non-workout workout!

Whatever form – or forms – of aerobic activity you chose, doing at least 150 minutes a week at moderate intensity, or 75 minutes if you’re really going for it, together with at least two sessions of strengthening exercise, can significantly reduce your risk of developing circulatory diseases and a whole host of other serious health conditions, as well as boosting your overall wellbeing. And it doesn’t have to involve fancy equipment, keeping up with the latest fitness trends or expensive health club memberships.

“Remember, you don’t have to go to the gym to do strength exercise,” says Jemelle, “it can be done at home with no equipment… Squats, push-ups and dips are examples of strengthening exercises that can be done anywhere. You can also alter them to make it easier or more difficult, depending on your fitness level, for example by doing kneeling push ups or sit to stand squats.” 

To get motivated to exercise regularly, try joining a local group – dancing, rambling, football, netball or cycling – so you can exercise with others. Or pair up with friend or colleague as an exercise buddy.

Setting yourself challenges can also be a great way to keep motivated. For example, aim to walk every day, or jog for 1km daily for two weeks, or sign up for an organised event that you’ll need to work towards.

One final tip, find something you enjoy doing and it won’t seem like an effort at all. Plus, you’re far more likely to stick to your new routine! Take a look at our article for more on fitting change into your lifestyle.

Three-minute circulation booster

Exercise doesn’t need to be time-consuming. To get your blood pumping, try this three-minute circulation booster. Try adding it to an activity you already (waiting for your morning tea to brew, for example) do so that it becomes a habit

  • Start marching on the spot for 20 marches. Keep your shoulders pulled back, back straight, stomach muscles pulled in.

  • Continue marching, adding shoulder rolls – lift both shoulders to your ears, then back and forwards, for 20 counts.

  • Finish with 10 alternating knee lifts, bringing each knee up to your opposite elbow.

Remember that if you have an existing circulatory problem speak to your doctor before trying new forms of exercise or increasing activity levels. “Very high intensity exercise could reduce the amount the oxygen reaching your heart, or another part of your body, which could be damaging,” warns Registered Nurse, Sarah.

However, “Done properly, people with circulation problems have even more to gain from regular exercise than the rest of the population.”

More ways to improve circulation naturally

While exercise is really important to protect yourself from heart and circulatory problems, there are plenty of other lifestyle changes you can make to improve, prevent or even reverse poor circulation, and give your overall health a boost. The chances are they’ll also leave you looking and feeling great, so all the more reason to give them a go! 

  • Not smoking, or quitting smoking if you do – According to the NHS, smoking doubles your risk of having both a heart attack and a stroke. If you smoke, you also have twice the risk of dying from either of these events than someone who has never smoked. However, you can start to reverse this damage from the moment you quit, so it’s never too late to try. According to the NHS’ Smokefree website, after only one year of not smoking, your risk of heart attack is reduced by half and after 15 years, your risk is similar to that of a lifetime non-smoker. And within two years of stopping smoking, your risk of stroke is reduced to half that of a smoker and within five years it will be the same as a non-smoker.6

  • Eating a heart-healthy diet – “that means one that’s high in fibre, low in salt (no more than 6g of salt/2.4g of sodium per day – equivalent to one teaspoon) and low in sugar,” explains Rita. “You should also try to include lots of different fruits and vegetables and limit you intake of saturated (animal) fats – replacing these with unsaturated (omega 3 and 6) fats where possible.”

    “Having a healthy diet is one of the best ways to boost heart health and prevent circulatory disease in the future, because you’ll be less likely to be overweight or obese, or to develop high blood pressure, raised cholesterol and type 2 diabetes – all of which are major risk factors for CVD.”7  For help with this, take a look at our article Ten ways to develop healthy eating habits.

  • Keeping your weight within healthy limits – there’s plenty of evidence to suggest that being overweight or obese increases your risk of developing disease and of developing it at a younger age.8  For one thing, it puts extra strain on your heart when it comes to pumping blood around your body;  you’re also more likely to develop medical problems, which themselves can cause heart disease, such as high blood pressure and raised cholesterol.

    “It’s also important to pay attention to your waist measurement as this is a risk factor for diseases such as high blood pressure, diabetes and coronary heart disease,” says Rita. “A larger waist measurement would indicate that there are excess levels of fat inside your organs. For males, aim for a waist measurement of no higher than 94cm (37in) and females should aim for a waist measurement of no higher than 80cm (31.5in).”

    The good news is that losing just 10% of your body weight can significantly reduce your CVD risk and even modest weight loss, of just 5-10% of body weight can improve your heart health.9

  • If you’re diabetic, keeping blood sugar levels to normal limits – Adults with diabetes are 2-3 times more likely to develop heart and circulatory diseases. “This is due to the high levels of glucose present in the blood stream, which can make the red blood cells “sticky” and cause them to build up together along the walls of the blood vessels, forming clots,” says Rita. “This can build up over time, leading to high blood pressure as more force is required for the blood to pass through, which in turn can cause damage to the inner lining of the blood vessels.”

You can reduce – or even reverse - that risk by careful management of your blood sugar levels, through lifestyle factors, medication or a combination of both. Our article How to curb your enthusiasm for sugar may help.

Medication for heart and circulatory problems

Medicines are available to treat heart and circulatory problems. They will usually only be prescribed in severe cases or as a last resort if changes to diet and lifestyle (the preferred first line of treatment) aren’t enough to reduce a patient’s risk of CVD. If it does become necessary to take medication, there are various types that work in different ways: by lowering blood pressure, reducing cholesterol levels, widening the arteries or thinning the blood to prevent clotting.

A combination of these may be required to manage your symptoms effectively and it can take a while for you and your GP to work out a regime that’s right for you. If you do take medication for heart or circulatory disease it’s important to take it as instructed and not stop taking it suddenly, as this can be damaging. It’s also important to also try to incorporate some or all of the lifestyle changes listed here as well, to really look after your heart health for the longer term.

Further information

If you have a question about circulation, heart health, getting more active, or any other aspect of your health and wellbeing, our Health at Hand team are available to support you, at any time of the day and night. Simply post your question online using our Ask the expert service and one of our team of nurses, midwives and pharmacists will get back to you with an answer as soon as they are able to. You’ll usually hear back within a couple of hours but it could take up to 24 hours to respond, depending on the nature of your enquiry and availability of appropriately qualified experts.

You'll find lots more expert-led information, tips and inspiration to get you moving more and help keep you motivated in our exercise and fitness pages. Plus take a look at our heart hub for further ways to improve your cardiovascular health.

Additional resources

Ten ways to develop healthy eating habits – AXA PPP healthcare

How to curb your enthusiasm for sugar – AXA PPP healthcare

The health benefits of gardening – AXA PPP healthcare

The health benefits of exercising outdoors - AXA PPP healthcare

The benefits of group exercise – AXA PPP healthcare

Fitting change into your lifestyle – AXA PPP healthcare

British Heart Foundation 

Heart UK 

References

1. Lavie CJ, Ozemek C, Carbone S, Katzmarzyk PT, Blair SN. Sedentary behavior, exercise, and cardiovascular health. Circ Res. 2019; 124:799–815. doi: 10.1161/CIRCRESAHA.118.312669.

2. Department of Health and Social Care (2019) UK Chief Medical Officers' Physical Activity Guidelines. The Stationery Office.

3. DH (2019) News release: UK Chief Medical Officers' Physical Activity Guidelines.

4. Laura A Talbot, Christopher H Morrell, Jeffrey Metter, Jerome L Fleg. Comparison of cardiorespiratory fitness versus leisure time physical activity as predictors of coronary events in men aged ≤65 years and >65 years. The American Journal of Cardiology Volume 89, ISSUE 10, P1187-1192, May 15, 2002.

5. Duck-chul Lee, Russell R. Pate, Carl J. Lavie, Xuemei Sui, Timothy S. Church, Steven N. Blair. Leisure-Time Running Reduces All-Cause and Cardiovascular Mortality Risk. J Am Coll Cardiol. 2014 Aug, 64 (5) 472-481.

6. The health & wellbeing benefits of swimming (June 2017). Commissioned by Swim England’s Swimming and Health Commission, chaired by Professor Ian Cumming.

7. NHS Smokefree website: What happens when you quit (Accessed 23 June 2020).

8. Case Western Reserve University. "Obesity is shifting cancer to young adults: Obesity can also alter a young person's likelihood of developing cancer later in life." ScienceDaily. ScienceDaily, 26 March 2018.

9. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481-1486. doi:10.2337/dc10-2415.