Water-based exercise for heart health

Gentle, joint-friendly water workouts like swimming, aqua aerobics and water walking can strengthen your heart, boost fitness and support recovery.

Benefits of exercising in water

Water has natural properties that make it ideal for building fitness for your heart and lungs.

Buoyancy reduces strain. Water supports up to 90% of your body weight, reducing impact on joints, bones and muscles. This makes it a great option if you have arthritis, joint pain, or are returning to exercise after a break or a cardiac event.
Natural resistance builds strength. Water is denser than air, so every movement works your muscles harder. Even simple movements like walking or lifting your arms become gentle resistance training.
A cardiovascular workout. Water-based activities raise your heart rate and breathing rate, improving heart and lung fitness. Regular aerobic exercise strengthens the heart muscle so it can pump blood more efficiently
Lower blood pressure over time. Research shows that regular aquatic exercise can meaningfully reduce your resting blood pressure. A 10-week programme of water aerobics significantly lowers blood pressure which reduces stroke and heart disease risk.
Good for your mind, too. Exercise in water has been shown to reduce stress and improve mood. Joining a group aquatic class can also reduce social isolation an under recognised risk factor for heart disease.
A safe environment to build confidence. For people who have recently had a fall, feel unsteady, or are recovering from surgery, the pool removes the fear of falling that can make land-based exercise feel daunting. This makes it easier to stay consistent which is important for heart health.

Is water exercise safe if you have a heart condition?

For many people living with heart disease, water-based exercise can be a safe and effective option. However, it’s important to speak with your doctor or cardiac rehabilitation team first.

The pressure of water on the body can slightly increase the workload on the heart, particularly in deeper water or cooler temperatures. This means professional guidance is important if you:

have recently had heart surgery or a cardiac event
have uncontrolled heart failure
experience unstable angina or significant rhythm problems.

If you’ve completed cardiac rehabilitation, your health team can advise whether aquatic exercise is suitable and what intensity is right for you.

Water-based exercises to try

Older adults taking part in aqua aerobics class, doing water based exercise for heart health and low impact fitness in a swimming pool.

You don’t need to be a strong swimmer to benefit from water. Here are some simple exercise options:

1. Water walking

Walk in knee to waist-deep water, swinging your arms naturally. You can do this in the pool or at a safe, sandy beach. To increase intensity, walk faster or move into deeper water. Aim for 10–20 minutes to start, building up gradually

2. Aqua jogging

At the pool, in deeper water, use a flotation belt and mimic a jogging motion. This provides a strong cardio workout with minimal joint impact.

3. Aqua aerobics classes

Group classes combine rhythmic movements, arm exercises and leg work, often using foam dumbbells or kickboards. They’re social, structured and suitable for many fitness levels.

4. Swimming laps

Swimming provides a full-body workout. Start with short intervals, for example, one lap followed by rest, and gradually build endurance as it becomes easier.

5. Simple resistance moves

Try the following moves in chest-deep water.

Push and pull your arms through the water.
Perform gentle squats.
Lift your knees towards your chest one at a time.
If you’re in a pool, hold onto the edge and do flutter kicks.

Because water provides constant resistance, slow, controlled movements are the most effective.

How much is enough?

Adults should aim for at least 150 minutes of moderate-intensity aerobic activity each week. Water-based exercise counts toward this target.

Moderate intensity means you’re breathing harder but can still hold a conversation. If you’re new to exercise, start with 10–15 minutes and gradually build up. Even small increases make a difference. Consistency across the week matters more than any single long session.

Tips for getting started safely

Warm up for 5 minutes with gentle walking or arm movements
Stay hydrated, even though you may not feel sweaty
Cool down slowly before leaving the pool
Stop if you feel chest pain, dizziness, or unusual shortness of breath
Choose a pool with easy-access steps or a ramp if you have joint or mobility challenges

How hard should you work? Understanding exercise intensity in water

One of the most common questions about water exercise is knowing whether you're working at the right intensity. Here's what you need to know:

Heart rate behaves differently in water.

Immersion in water can cause a lower heart rate response than the same level of effort on land. This is partly due to the cooling effect of water and the way immersion affects blood distribution in the body. This means you should not rely on heart rate alone to judge whether you are working hard enough.

Use the "talk test" as your guide.

Moderate intensity means you can still hold a conversation but are breathing noticeably harder. If you can sing easily, you may need to push a little more. If you can't speak in short sentences, ease back.

The Rating of Perceived Exertion (RPE) scale

RPE is another simple and reliable way to monitor effort, it asks you to rate how hard you feel you are working on a scale from 1 (no exertion) to 10 (maximum effort). For moderate-intensity aquatic exercise, aim for a perceived effort of around 4-6 ("moderate to somewhat hard").

Always gradually increase duration before intensity.

A good rule of thumb: build the length of your sessions before you increase how hard you work. This is especially important if you're new to exercise or returning after a cardiac event.

Is cold water swimming safe for heart health?

Cold water swimming is becoming increasingly popular and can be beneficial for those in good general health. However, it places extra demands on the heart

Suddenly entering very cold water can trigger a “cold shock” response with a rapid rise in heart rate and blood pressure, along with shortness of breath. For some people, it may trigger abnormal heart rhythms and in rare cases even cardiac arrest.

Because of this, people with a heart condition should talk with their doctor before starting cold water swimming and may be safer choosing a heated pool instead.

A final word

Water-based exercise offers a refreshing, low-impact way to strengthen your heart, build fitness and improve overall wellbeing. Whether you’re returning to activity, managing joint discomfort, or simply looking for variety, the pool can be a powerful place to support your heart health.

If you’re unsure where to begin, talk to your healthcare professional about the right level of activity for you — and consider checking your local pool for beginner or heart-friendly classes.