Why Resting Heart Rate Matters: Key Health Insights
Discover the vital role your resting heart rate plays in your overall health. Learn how to interpret its significance, factors affecting it, and steps to maintain a healthy heart rate. Uncover key insights to improve your well-being, including role of exercise.
DR T S DIDWAL MD
8/3/20249 min read
According to a review in Trends in Cardiovascular Medicine Resting heart rate (RHR) is a crucial health indicator, reflecting the number of times your heart beats per minute while at rest. Typically, a normal RHR for adults ranges from 60 to 100 bpm, with well-conditioned athletes potentially having lower rates. RHR is influenced by factors such as age, fitness level, stress, hormones, medications, and hydration status.
A higher RHR is linked to increased risks of all-cause mortality, cardiovascular disease, heart failure, coronary artery disease, sudden cardiac death, stroke, cancer, diabetes, and hypertension. Potential mechanisms include increased cardiac workload, reduced diastolic filling time, elevated blood pressure, autonomic imbalance, oxidative stress, arterial stiffness, and metabolic disturbances.
To measure RHR accurately, choose a relaxed time, avoid recent eating or exercise, and take multiple readings over several days. Factors affecting RHR include body position, time of day, stress, temperature, altitude, medications, caffeine, nicotine, hormones, and hydration.
Lowering RHR can be achieved through regular aerobic exercise, stress management, sufficient sleep, hydration, maintaining a healthy weight, and limiting alcohol and caffeine. Quitting smoking and consulting a doctor about medications is also advisable. Monitoring RHR offers valuable insights into cardiovascular health and overall well-being, emphasizing the importance of heart-healthy habits.
Key points
Resting Heart Rate as a Health Indicator: Your resting heart rate, the number of times your heart beats per minute when you're at rest, can reveal a lot about your overall health and predict your risk of future medical issues.
Health Risks of High Resting Heart Rate: Higher resting heart rates are associated with increased risks of all-cause mortality, cardiovascular disease, heart failure, coronary artery disease, sudden cardiac death, stroke, cancer, diabetes, and hypertension.
Potential Mechanisms: A faster-resting heart rate may be harmful due to increased cardiac workload, reduced diastolic filling time, higher blood pressure, autonomic imbalance, increased oxidative stress, arterial stiffness, and metabolic disturbances.
Measuring and Understanding Resting Heart Rate: To accurately measure your resting heart rate, choose a relaxed time, wait after eating or exercising, and take multiple measurements over several days. Factors influencing heart rate include age, fitness level, body position, time of day, stress, temperature, altitude, medications, caffeine, nicotine, hormones, hydration, and recent physical activity.
Improving Resting Heart Rate: Strategies to lower your resting heart rate include regular aerobic exercise, managing stress, getting enough sleep, staying hydrated, maintaining a healthy weight, limiting alcohol and caffeine, quitting smoking, and consulting your doctor about medications.
The Importance of Resting Heart Rate: More Than Just a Number
When you visit the doctor, one of the first things they typically do is measure your resting heart rate. But have you ever wondered why this simple number is so important? As it turns out, your resting heart rate can reveal a lot about your overall health and even predict your risk of future medical issues. Let's take a deep dive into the fascinating science behind resting heart rate and why it matters.
What is resting heart rate?
Your resting heart rate is simply the number of times your heart beats per minute when you're at rest. For most adults, a normal resting heart rate falls between 60 to 100 beats per minute (bpm). However, well-conditioned athletes may have resting heart rates as low as 40 bpm.
Resting heart rate is controlled by a complex interplay of factors in your body. The primary driver is your heart's natural pacemaker cells in the sinoatrial node. But your heart rate is also heavily influenced by your autonomic nervous system—specifically, the balance between your sympathetic "fight or flight" system and your parasympathetic "rest and digest" system.
Other factors that can affect your resting heart rate include:
Age
Fitness level
Stress
Hormones
Medications
Hydration status
Body position
Time of day
Why Resting Heart Rate Matters
You might think that as long as your resting heart rate falls within the normal range, there's nothing to worry about. However, a large body of research has shown that resting heart rate is actually a powerful predictor of health outcomes and mortality risk—even within the "normal" range.
Numerous large, long-term studies have found that higher resting heart rates are associated with increased risk of:
All-cause mortality
Cardiovascular disease and death
Heart failure
Coronary artery disease
Sudden cardiac death
Stroke
Cancer
Diabetes
Hypertension
For example, one meta-analysis looked at data from over 1.2 million people and found that for every 10 bpm increase in resting heart rate, there was:
9% higher risk of all-cause mortality
8% higher risk of cardiovascular mortality
11% higher risk of coronary heart disease
18% higher risk of sudden cardiac death
18% higher risk of heart failure
These associations held true even after accounting for other cardiovascular risk factors. The increased risks were seen across the full range of heart rates, with no clear threshold. However, the risks became especially pronounced at rates above 80-90 bpm.
Interestingly, the relationship between resting heart rate and mortality appears to be stronger in men compared to women. The reasons for this are not entirely clear, but may relate to differences in autonomic nervous system function between the sexes.
It's important to note that these studies show correlation, not necessarily causation. A higher resting heart rate may be a marker of poor health rather than a direct cause of disease. However, some evidence suggests that heart rate itself may have harmful effects on the cardiovascular system over time.
Potential Mechanisms
So why exactly might a faster resting heart rate be detrimental to health? There are a few potential mechanisms:
Increased cardiac workload - A faster heart rate means your heart has to work harder over time, which may lead to earlier cardiac "wear and tear."
Reduced diastolic filling time - Less time between beats means less time for the heart to fill with blood, potentially reducing cardiac efficiency.
Increased blood pressure - A faster heart rate tends to increase blood pressure, placing more stress on blood vessels.
Autonomic imbalance: A high resting heart rate may reflect an overactive sympathetic nervous system and/or an underactive parasympathetic system. This autonomic imbalance is associated with various health issues.
Increased oxidative stress: Animal studies suggest that higher heart rates may increase oxidative stress in the body.
Arterial stiffness: Faster heart rates are associated with increased arterial stiffness, a risk factor for cardiovascular disease.
Metabolic effects: Higher resting heart rates are linked to insulin resistance and other metabolic disturbances.
Can lowering the heart rate improve health?
Given the associations between high resting heart rate and poor health outcomes, an obvious question is whether intentionally lowering heart rate can reduce risks. The answer is somewhat complex.
In patients with existing cardiovascular disease, lowering the heart rate does appear to be beneficial in many cases. For example, beta-blocker medications that reduce heart rate have been shown to improve survival after heart attacks and in patients with heart failure. The heart rate-lowering drug ivabradine has also shown benefits in some heart failure patients.
However, the picture is less clear for healthy individuals without cardiovascular disease. Some studies have found that physical activity that lowers resting heart rate is associated with reduced mortality risk. But it's difficult to separate the effects of lower heart rate from the many other benefits of exercise.
Pharmacologically lowering heart rate in healthy people has not been well-studied and may not necessarily be beneficial. For instance, the SIGNIFY trial found that lowering heart rate with ivabradine in patients with stable coronary artery disease but normal heart function did not improve outcomes and may have increased risk in some patients.
Overall, while a lower resting heart rate is generally associated with better health outcomes, we can't say for certain that artificially lowering heart rate will always be beneficial. The ideal approach is likely to focus on overall cardiovascular health through lifestyle measures like regular exercise, stress management, and a healthy diet. These interventions tend to naturally lower resting heart rate while providing many other health benefits.
Factors That Affect Resting Heart Rate
Understanding the factors that influence resting heart rate can help you interpret and potentially improve your own heart rate:
Age: Resting heart rate tends to increase slightly with age.
Fitness level: Regular aerobic exercise is one of the most effective ways to lower the resting heart rate.
Body position: The heart rate is typically lowest when lying down and highest when standing.
Time of day: Heart rate follows a circadian rhythm, usually lowest in the early morning and highest in the afternoon/evening.
Stress and emotions: psychological stress and strong emotions can significantly increase the heart rate.
Temperature: Both high and low temperatures can increase the heart rate.
Altitude: Higher altitudes tend to increase the resting heart rate.
Medications: Various medications can either increase or decrease heart rate.
Caffeine and nicotine tend to increase heart rates.
Hormones: Thyroid hormones and stress hormones like cortisol can affect heart rate.
Hydration status: dehydration typically increases the resting heart rate.
Recent physical activity: It can take some time for heart rate to fully return to baseline after exercise.
Measuring Your Resting Heart Rate
To get an accurate measure of your true resting heart rate:
Choose a time when you're relaxed, preferably in the morning before you get out of bed.
Wait at least 2 hours after eating, consuming caffeine, or exercising.
Sit or lie quietly for at least 5 minutes.
Count your pulse for 30 seconds and multiply by 2 (or count for a full minute for greater accuracy).
Take multiple measurements over several days and average the results.
Many wearable devices now offer continuous heart rate tracking, which can provide useful long-term data on your resting heart rate trends. However, these devices may not always be as accurate as manual measurements, especially during exercise.
What's a Healthy Resting Heart Rate?
While 60–100 bpm is considered the normal range, lower rates within this range are generally associated with better health outcomes. A good target for most adults is a resting heart rate between 50-70 bpm.
However, it's important to remember that heart rate is highly individual. What's "normal" for you may depend on various factors, including age, fitness level, and overall health status. Sudden changes in your typical resting heart rate are often more meaningful than the absolute number.
If you're concerned about your resting heart rate, especially if it's consistently above 100 bpm or below 60 bpm (unless you're a trained athlete), it's best to consult with a healthcare provider.
Improving Your Resting Heart Rate
If you'd like to lower your resting heart rate, here are some evidence-based strategies:
Regular aerobic exercise is one of the most effective ways to lower your resting heart rate over time.
Manage stress. Chronic stress can keep your heart rate elevated. Techniques like meditation, deep breathing, and yoga can help.
Get enough sleep. Poor sleep is associated with higher resting heart rates.
Stay hydrated. Proper hydration helps your heart pump blood more efficiently.
Maintain a healthy weight. Excess weight often correlates with higher resting heart rates.
Limit alcohol and caffeine. Both can increase heart rate, especially when consumed in large amounts.
Quit smoking. Nicotine increases heart rate and blood pressure.
Consider your medications. Some medications can affect your heart rate. Never stop or change medications without consulting your doctor.
Resting Heart Rate (RHR) and Exercise
This study, published in the Journal of Clinical Medicine, aimed to investigate the impact of different types of exercise on resting heart rate (RHR) in healthy individuals. RHR is known to be positively linked to mortality, while regular exercise is associated with lower RHR.
Methodology: Researchers conducted a comprehensive review of 191 studies involving 215 samples. These studies examined various exercise types, including endurance, strength, combined training, yoga, tai chi, and qigong.
Findings: The results consistently showed that all types of exercise led to a decrease in RHR. However, only endurance training and yoga produced statistically significant reductions in RHR for both men and women. The degree of RHR reduction was influenced by initial heart rate levels and participant age, with higher starting RHRs and younger age groups experiencing greater decreases.
Implications: The study suggests that regular exercise, particularly endurance training and yoga, can contribute to a lower RHR. Given the established link between RHR and mortality, these findings support the notion that exercise may help reduce the risk of death from various causes. While further research is needed to definitively establish a causal relationship between RHR reduction and mortality, the results of this study highlight the potential benefits of exercise for cardiovascular health and overall well-being.
Key points:
Regular exercise lowers the RHR.
Endurance training and yoga have the most significant impact on RHR.
A lower RHR is associated with reduced mortality risk.
Exercise may contribute to increased lifespan and better health
Conclusion
Your resting heart rate is much more than just a number—it's a window into your overall health and a powerful predictor of future health outcomes. While a single heart rate measurement doesn't tell the whole story, tracking your resting heart rate over time can provide valuable insights into your cardiovascular health and overall well-being.
Journal Reference
Olshansky, B., Ricci, F., & Fedorowski, A. (2023). Importance of resting heart rate. Trends in Cardiovascular Medicine, 33(8), 502–515. https://doi.org/10.1016/j.tcm.2022.05.006
Reimers, A. K., Knapp, G., & Reimers, D. (2018). Effects of Exercise on the Resting Heart Rate: A Systematic Review and Meta-Analysis of Interventional Studies. Journal of Clinical Medicine, 7(12). https://doi.org/10.3390/jcm7120503
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