3 exercises that are best for heart health

Whatever your heart or circulatory condition, you’ll have something to gain from exercise. Getting active could help to ease your symptoms, help you do more in your daily life, and stop your disease from getting worse.

Helen Alexander, a physiotherapist who specialises in cardiac rehabilitation at Nuffield Health at St Bartholomew's Hospital, has the lowdown on the best types of exercise – and how you might need to adapt it, depending on your condition:

Aerobic exercise

What is aerobic exercise?

Aerobic exercise is where you’re moving your body’s largest muscles, such as the ones in your arms and legs, in a way that makes you warm and slightly out of breath.

Aerobic exercise examples include walking, cycling, and swimming but also everyday activities such as doing housework, gardening, or playing with your children or grandchildren.

Benefits of aerobic exercise?

“Aerobic exercise helps your heart and circulatory system to work better, so you are more able to do daily tasks without getting tired or breathless,” explains Mrs Alexander. “It can also improve your emotional wellbeing and how well you sleep.”

How does aerobic exercise help prevent cardiovascular disease?

Aerobic exercise also lowers your risk of heart and circulatory diseases, and can help stop them getting worse by:

• lowering your resting blood pressure and heart rate
• improving your cholesterol levels
• helping you keep to a healthy weight, which in turn reduces your risk of developing type 2 diabetes

How much aerobic exercise a week?

It’s recommended you do at least 150 minutes a week of moderate-intensity aerobic exercise.

“Moderate intensity means you feel warm and comfortably breathless,” says Mrs Alexander. “If you are new to exercise, build up gradually to 150 minutes. Start by doing 5 to 10 minutes each day. Listen to how your body feels the next day before doing more.”

Who's it for?

Everyone with a heart or circulatory condition should do aerobic exercise, but you might need to adapt how hard you push yourself, depending on your condition and fitness level. So, it’s important that you chat about any new exercise with your health professional.

If you’ve just had heart surgery, or an event such as a heart attack, it is important to get advice on how to return to exercise safely. Ask for a referral to your local cardiac rehabilitation team.

If you have heart failure, you may need to build up the amount of exercise you do more gradually. Seek advice from your cardiac rehab team or heart failure specialist, and get tips here.

Warming up before exercise and cooling down afterwards is important, for everyone, but especially if you have angina.

“If you get angina symptoms while being active, rest until they’re gone. Always carry your GTN spray and use it as you’ve been advised,” says Mrs Alexander. You can also read our tips.

If you have an implantable cardioverter defibrillator (ICD), find out from your specialist what heart rate level you should aim to stay below to avoid an inappropriate shock from the device.

For people with peripheral arterial disease (PAD), walking can be particularly helpful: you should see the pain in your legs lessen over time the more often you walk, so keep going despite the discomfort.

If you can’t walk or find it difficult to balance, you can still do aerobic exercise by moving your arms and top half of your body, for example you could try out these seated exercises.

There are also specialised bikes such as handcycles and trikes. Wheels for All (01925 575 628) is a charity that offers inclusive cycling at centres across England, or you could speak to your local bike shop or disability organisation.

Resistance training

What is resistance exercise?

Strength exercises – also known as resistance training – are designed to make your muscles work harder.

“These could involve lifting weights or using resistance equipment such as bands or cables. But you can just use your own body weight. Perhaps start with moving from sitting to standing out of a chair, then progress to doing squats or press-ups against the wall,” explains Mrs Alexander.

Why do resistance training?

“Strengthening our muscles means that your arms and legs will work better and that will take the demand off your heart,” explains Mrs Alexander. “The stronger your muscles are, the easier you’ll find it to do aerobic exercises and everyday tasks without getting so breathless and tired.”

How often should I do resistance training?

Do strength training 2 to 3 days a week, ideally spread out across the week, so you have at least a day’s recovery time in between.

“Start with an exercise that you can repeat 10 to 12 times, with the last couple repetitions starting to feel a bit challenging. If you can, do 2 to 3 sets of these 10-12 repetitions,” says Mrs Alexander.

Mrs Alexander says it’s important you don’t hold your breath during strength training, as this can increase your blood pressure. “If you can’t breathe and talk normally while doing strength training, this suggests the load you’re lifting is too heavy.”

Who’s it for?

Everyone should do some form of strength training, but if you have certain heart conditions, such as heart failure, or have recently had surgery you’ll have to gradually build up your strength – chat with your health specialist before starting.

If you’ve had heart surgery, in the first few weeks following surgery you should keep your elbows by your side when lifting any amount of weight, to reduce the strain on your chest, and don’t lift anything heavier than a half-full kettle.

If you’ve had an ICD fitted, for 6 weeks afterwards avoid lifting your arm above shoulder height on the side it was fitted (which will usually be the left arm).

People who have PAD should focus on strengthening the muscles where they experience symptoms – for example, if you get pain in your calf, then calf raising exercises could help.

As we get older, our muscles naturally lose strength, so it’s even more important to do resistance training.

Balance exercises and flexibility exercises

What is it?

Yoga, pilates and tai chi are all examples of exercises that help improve your flexibility and balance. But you don’t need to set aside big blocks of time to work on flexibility and balance. You could include stretches and balance exercises into your other exercise sessions.

Flexibility exercises are best done when your muscles are already warm, so why not add on some stretches after you do aerobic exercise? After walking, for example, you could do a calf stretch.

Balance exercises are where we move into a position that is less stable and get our body to hold the position.

“It could be something as simple as standing with 1 foot in front of the other,” explains Mrs Alexander. “You could stand on 1 leg while holding something to support you, like a kitchen worktop, and then gradually try doing that without so much support.”

• Get more ideas for balance exercises.

What are the benefits?

Flexibility exercises make sure muscles don’t get too tight. This helps you to move more easily and avoid pain or injury. Balance exercises reduce the risk of you having falls.

How much?

Try to do balance and flexibility exercises 2 to 3 days a week. Gradually ease into a position where you feel a “comfortable tightness”, but it shouldn’t feel painful to hold the stretch.

Try to hold muscle stretches for at least 30 seconds (the time it takes to count to 30, slowly) – but make sure you’re not holding your breath.

Who’s it for?

Everyone with a heart or circulatory condition can do balance and flexibility exercises, but if you are on blood pressure medication you’ll need to take particular care.

“If you move quickly from lying down to standing, or sitting to standing, this can cause your blood pressure to drop and can make you feel dizzy or lightheaded,” explains Mrs Alexander. “Make sure you move slowly out of different positions.”

• Visit our activity section for more ideas and tips on improving your health

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