Circulatory System

Overview

Your circulatory system is the network that moves blood around your body. It is made up of your heart, your blood vessels (tubes called arteries, veins and capillaries) and your blood itself. Your heart works like a pump, pushing blood through the vessels to every part of your body. The blood carries oxygen and nutrients to your organs, muscles and skin, and carries waste products away. When everything works well, you don't notice it at all. When part of the system becomes narrowed, blocked, damaged or leaky, you can get symptoms such as cold hands, swollen legs, chest pain or breathlessness. Problems with the circulatory system are often called cardiovascular disease, which simply means disease of the heart and blood vessels.

Yes. Everyone has a circulatory system, and problems with it are very common. Conditions such as high blood pressure, narrowed arteries, varicose veins and leg swelling affect millions of people. The good news is that most of these problems can be prevented, spotted early or managed well.

Anyone can be affected, at any age. Some circulatory problems run in families or are present from birth. Most, however, become more common as people get older, and are more likely in people who smoke, have high blood pressure, high cholesterol, diabetes or kidney disease, carry extra weight, or are not very active.

Symptoms

Common symptoms

• Cold hands and feet, or fingers that change colour in the cold
• Swelling in the ankles, feet or legs, especially by the end of the day
• Feeling tired or short of breath more easily than before
• Chest tightness or discomfort when walking uphill or hurrying
• Cramping pain in the calves when walking that eases with rest
• Visible, twisted veins in the legs
• Numbness, tingling or a heavy feeling in the limbs
• Cuts or sores on the feet or legs that heal slowly
• A pounding, fluttering or racing heartbeat

Symptoms in children

• Most children have healthy circulation, but signs to notice include blue tinge to the lips or skin
• Feeding slowly or sweating a lot during feeds in babies
• Getting tired or breathless quickly when playing
• Fainting or dizziness, especially during exercise
• Swelling of the hands, feet or around the eyes

Symptoms in older adults

• Swelling in the legs that builds up over the day
• Cramp in the legs when walking that stops with rest
• Dizziness or light-headedness when standing up quickly
• Cold, pale or shiny skin on the feet and legs, or slow-healing wounds
• Memory changes or tiredness, which can sometimes be linked to reduced blood flow

Causes

Main causes

• Furring or narrowing of the arteries over time, called atherosclerosis. This is a build-up of fatty material inside the artery walls.
• High blood pressure, which puts extra strain on the heart and blood vessels
• High cholesterol and other fats in the blood
• Blood clots that block an artery or vein
• Problems with the heart valves or the heart muscle
• An irregular heartbeat, which can reduce how well the heart pumps
• Weakened vein walls or valves, which can cause varicose veins and swelling
• Narrowing or spasm of small blood vessels, such as in Raynaud's, where fingers turn white in the cold
• Conditions present from birth (congenital heart problems)

Risk factors

• Smoking or vaping
• High blood pressure, high cholesterol or diabetes
• Being overweight, especially around the waist
• Not being physically active
• Eating a lot of salty, fatty or highly processed food
• Drinking too much alcohol
• Long periods of sitting or standing still
• A family history of heart or circulation problems
• Getting older
• Kidney disease, sleep apnoea or other long-term conditions
• Stress and poor sleep, which affect blood pressure and heart health

When to see a doctor

See a doctor urgently if:

• Chest discomfort, even if it comes and goes
• Sudden swelling in one leg
• New breathlessness, or breathlessness that is getting worse
• A foot or leg wound that is not healing, or skin that is turning dark
• A heartbeat that feels very fast, very slow or irregular

Book a routine appointment if:

• Cold hands and feet that bother you
• Leg cramps when walking
• Swollen ankles that keep coming back
• Varicose veins that ache or look unsightly
• A family history of early heart disease or high cholesterol
• You want a blood pressure and cholesterol check

Diagnosis

A doctor will start by talking with you about your symptoms, your health history and your family, then examine you. They may check the pulses in your wrists, groin and feet, listen to your heart and lungs, measure your blood pressure, and look at your legs, feet and skin. From there, they can arrange simple tests. Many circulation problems can be spotted with a quick check in a GP surgery or clinic.

Tests that may be done

• Blood pressure measurement
• Blood tests for cholesterol, blood sugar and kidney function
• An ECG (electrocardiogram), which records the electrical activity of your heart
• An echocardiogram, which is an ultrasound scan of the heart
• A Doppler ultrasound, which uses sound waves to check blood flow in the legs and neck
• An ankle-brachial index, which compares blood pressure in your ankle with your arm
• A heart monitor worn for a day or longer to catch an irregular heartbeat
• A stress test, which records your heart while you exercise
• CT or MRI scans, or an angiogram, which uses dye to show the inside of blood vessels

What to expect at your appointment

Most tests are quick, painless and done as an outpatient, so you can usually go home the same day. Some results are ready straight away, while blood tests and scans may take a few days. Your doctor will explain what each result means and talk through the next steps with you. It is fine to ask questions or bring someone with you.

Treatment

Treatment depends on what part of the circulatory system is affected and how much it is troubling you. In many cases, healthy daily habits do a great deal of the work. Where needed, doctors also use medicines and procedures to protect the heart and blood vessels and to relieve symptoms. The aim is to keep blood flowing freely, lower your risk of serious problems, and help you feel better day to day.

Self-care at home

• Move more: aim for regular activity such as brisk walking, cycling or swimming, building up gradually
• Stop smoking, and get help if you need it — this is the single biggest thing most people can do
• Cut down on salt and highly processed food, and eat more vegetables, fruit, beans, nuts and oily fish
• Keep alcohol within the recommended limits
• Keep to a healthy weight, and check your waist measurement
• Stand up and move around every hour if you sit for long periods
• Put your feet up when resting if your ankles swell
• Wear comfortable, well-fitting shoes and check your feet regularly, especially if you have diabetes
• Take any prescribed medicines as agreed, and ask your pharmacist if you are unsure

Medical treatments

Doctors may suggest medicines to lower blood pressure, lower cholesterol, prevent or break down blood clots, or help the heart pump more strongly. Some medicines relieve swelling or control an irregular heartbeat. Your healthcare team will choose what suits you, explain what it is for, and review it regularly. Never start, stop or change a medicine without speaking to them first. Procedures such as widening a narrowed artery with a small balloon and a mesh tube, bypass surgery, valve repair or surgery on veins are used when medicines and lifestyle changes are not enough.

When is surgery considered?

Surgery or a procedure may be suggested if an artery is badly narrowed, a valve is not working properly, a vein is causing real problems, or symptoms are limiting your daily life. Your team will explain the benefits and the risks, and the decision is always made together with you.

Living with this condition

Most people with a circulation problem live full, active lives. The key is routine: take medicines as agreed, keep moving, watch for changes in your symptoms, and go to your check-ups. It helps to know your own numbers — your blood pressure, cholesterol and weight — and to keep a simple note of new symptoms so you can describe them clearly at appointments.

Lifestyle tips

• Build activity into your day, such as a daily walk or taking the stairs
• Keep a regular sleep routine
• Find ways to manage stress, such as breathing exercises, hobbies or time outdoors
• Avoid long stretches of sitting still, especially on flights or long car journeys
• Keep warm in cold weather, and wear gloves if your fingers are sensitive to cold
• Ask your pharmacist before taking any new over-the-counter medicine, as some affect blood pressure

Diet and exercise

A heart-friendly way of eating means plenty of vegetables, fruit, whole grains, beans, lentils, nuts and seeds, with oily fish once or twice a week and less red and processed meat. Cut back on salt, sugary drinks and fried or packaged foods. For activity, aim for something that makes you slightly breathless but still able to talk — a brisk walk, swimming, dancing or cycling all count. Start where you are and build up slowly. If exercise brings on chest pain or severe breathlessness, stop and get medical advice.

Mental health and emotional wellbeing

Being told you have a heart or circulation problem can be worrying, and it is very normal to feel anxious or low at times. Some people feel frightened to exercise or to be far from home. These feelings usually ease as you learn more and gain confidence. Talking to your doctor, a nurse, a counsellor or a support group can really help. If you feel hopeless or have thoughts of harming yourself, please reach out for crisis support right away — contact your local emergency number or a crisis line in your country, and tell someone you trust.

Prevention

Many circulation problems can be prevented or greatly delayed. The main steps are not smoking, staying active, eating well, keeping a healthy weight, limiting alcohol, and getting blood pressure and cholesterol checked. Small, steady changes beat big sudden ones — even a ten-minute daily walk is a good start.

Vaccines

Some vaccines are recommended for people with heart or circulation conditions, as infections like flu can put extra strain on the heart. Ask your doctor or pharmacist which vaccines are advised for you.

Screening programmes

In the UK, the NHS Health Check is offered every five years to adults aged 40 to 74 and includes blood pressure, cholesterol and heart risk checks. Blood pressure can also be checked free at many pharmacies. If you have a family history of early heart disease, ask your doctor whether extra checks are right for you. Wherever you live, ask your local health service what routine checks are available.

Complications

If left untreated

• Heart attack, when blood flow to the heart muscle is blocked
• Stroke, when blood flow to part of the brain is blocked or a vessel bleeds
• Heart failure, when the heart becomes too weak to pump efficiently
• Kidney damage from long-term high blood pressure
• Narrowed leg arteries leading to pain, ulcers or, rarely, amputation
• Blood clots in the legs that can travel to the lungs
• A weakened, bulging artery wall, called an aneurysm

Long-term outlook

The outlook is encouraging. Most circulatory problems can be slowed, controlled or treated well, especially when they are found early. Millions of people live active, enjoyable lives with a heart or circulation condition. Keeping to your agreed treatment, staying active and attending your check-ups make the biggest difference — and your healthcare team is there to help you at every step.

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