Health

Resting heart rate: what the number says

For adults, a resting heart rate of 60 to 100 beats a minute counts as normal, and well-trained endurance athletes often sit at 40 to 60. Most readings land in the lower half of that band: across 92,457 wearable users in the United States tracked for 2 years, the mean daily value was 65.5. The number is worth knowing because it tracks risk: in a meta-analysis of 46 cohort studies with more than 1.2 million participants, every extra 10 beats a minute at rest went with a 9 percent higher relative risk of death from any cause.

What counts as normal

Resting heart rate is the number of times your heart beats in a minute while you are awake, still and calm. The reference range used by MedlinePlus, the health library of the US National Library of Medicine, is 60 to 100 beats a minute for adults. Children run faster: 70 to 110 at 7 to 9 years and 80 to 130 at 1 to 2 years. Well-trained athletes, whose hearts pump more blood with each beat, commonly sit at 40 to 60.

That range is wide because it is a statistical boundary, not a health target. In a 2020 study of 92,457 adults in the United States who wore a wrist tracker for at least 35 weeks, the mean daily resting heart rate was 65.5 beats a minute. Individual averages ran from 39.7 to 108.6, so two healthy people can differ by nearly 70 beats. Women had a higher rate than men in every age bracket, the average rose until roughly 50 years of age and then fell, and the lowest values appeared at a body mass index of 21 in women and 23 in men and in people sleeping 7 to 7.5 hours a night. The authors note that people who buy such devices are not representative of the wider population, so 65.5 is the middle of that group, not a national average.

Within one person the number is far steadier. Most participants saw their weekly average move by only about 3 beats, and about 80 percent never had a week in which it swung by 10 beats or more. That is the practical point: your own baseline, tracked over weeks, tells you more than a comparison with the population.

How to measure it so the number is worth reading

The cleanest reading is taken in the morning before you get up, or after at least 5 minutes sitting quietly. Place two fingers (not the thumb, which has a pulse of its own) on the inside of the wrist below the thumb, or on the side of the neck. Count the beats for a full 60 seconds. If you are short of time, count for 30 seconds and multiply by 2, or 15 seconds and multiply by 4; the shorter the count, the larger the rounding error, so use 60 seconds for a baseline.

Caffeine, a large meal, a hot room, a tense phone call or a flight of stairs will all push the number up for a while, so take readings under the same conditions each time. A single high reading means little. Five to 7 readings on consecutive mornings, then averaged, give a baseline you can trust.

Wrist devices estimate heart rate optically and calculate one resting value a day with a formula of their own; in the 92,457-person study that value was designed to approximate the pulse lying down just after waking, before getting up, so it can sit a few beats below a count taken sitting up. Both methods are useful, but do not mix them when you compare one week with the next. That study drew on nearly 33 million daily values from wrist devices of a single make.

What a higher number is associated with

One of the largest pooled analyses is a 2016 meta-analysis in the Canadian Medical Association Journal covering 46 prospective cohort studies. For all-cause mortality it drew on 1,246,203 people and 78,349 deaths; for cardiovascular mortality, on 848,320 people and 25,800 deaths. Each 10 beats a minute of higher resting heart rate was associated with a relative risk of 1.09 for death from any cause and 1.08 for cardiovascular death. Compared with the lowest category, people at 60 to 80 beats a minute had a relative risk of 1.12 for all-cause mortality, and people above 80 had a relative risk of 1.45. The dose-response curve, with 45 beats a minute as the reference, rose in a straight line for all-cause mortality, while cardiovascular mortality became significantly higher from 90 beats a minute upwards.

A common objection is that a fast resting pulse simply marks someone who is unfit. The Copenhagen Male Study tested exactly that. It followed 2,798 employed men aged 53 to 75, all in normal sinus rhythm and none with known heart disease or diabetes at the start, for 16 years, during which 1,082 died. Their fitness had been measured on a bicycle test 15 years before the heart rate reading. After adjusting for that fitness, for leisure-time activity, smoking, blood pressure and cholesterol, the risk of death still rose by 16 percent per 10 beats a minute. Men above 90 beats a minute had 3.06 times the risk of men at 50 or below, men at 81 to 90 had about twice the risk, and men at 51 to 80 had a risk 40 to 51 percent higher (1.40 at 51 to 60, 1.46 at 61 to 70, 1.51 at 71 to 80).

Three cautions. Every one of these figures is relative, not absolute: 1,082 of the 2,798 Copenhagen men died within the 16 years, and a hazard ratio of 3.06 multiplies that background risk rather than being a chance of dying in itself. These are observational studies, so they show association, not proof that lowering the pulse lengthens life. The meta-analysis authors also found substantial heterogeneity and evidence of publication bias; after correcting for it, the relative risk per 10 beats fell to 1.04. The direction is consistent across studies, but the size of the effect is less certain than the headline figures suggest.

What moves the number

Exercise is the lever with the best evidence. A 2018 systematic review pooled 191 controlled studies with 12,952 participants, with programmes lasting a median of 12 weeks at 3 sessions a week. Across all studies, exercisers lowered their resting heart rate by 3.3 beats a minute more than controls, about 4.7 percent; in men the difference was 4.3 beats. Endurance training (121 trials) and yoga (21 trials) were the two forms that lowered it significantly in both sexes, while strength training (43 trials) lowered it significantly in women only. Reductions were larger in people who started with a higher pulse and in younger participants. A drop of 3 to 4 beats is about a third of the 10-beat step used in the mortality studies, and no trial has tested whether the drop itself changes survival.

Other movers are shorter-lived. Dehydration, infection and fever push the rate up, which is why a morning pulse several beats above your baseline can be the first hint of an infection. Poor sleep, stress and caffeine late in the day do the same; the timing of the last cup matters here. Some medicines cut the rate, beta blockers most clearly; others, such as some asthma inhalers and decongestants, raise it. An overactive thyroid and anaemia both raise it persistently. Seasons matter a little: the wearable study found a peak in the first week of January and a low at the end of July, about 2 beats apart.

When the number needs a doctor

A resting pulse consistently above 100 beats a minute is called tachycardia, and it deserves a check even if you feel well, particularly if caffeine, illness or a bad night cannot explain it. Below 60 is bradycardia in the textbook sense, but in a fit person with no symptoms it is usually the sign of a well-trained heart. That reassurance does not hold for someone who is losing weight, eating very little or has an eating disorder, nor for anyone under 18: there a slow pulse is a warning sign and needs a medical check. Below 40, or a slow rate combined with dizziness, fainting, unusual tiredness or breathlessness, needs assessment.

Rhythm matters as much as rate. When you count your pulse, notice whether the beats are evenly spaced. An irregular pulse, with or without a racing feeling, can point to atrial fibrillation, which raises the risk of stroke and is treatable. Palpitations that come with chest pain, shortness of breath or fainting are an emergency. If you take blood pressure medication or thyroid medication, or have heart disease or long-standing diabetes, in which a persistently fast resting pulse can be a sign of nerve damage, discuss any sustained change of more than 10 beats from your usual baseline with your doctor rather than adjusting anything yourself. The same applies in pregnancy, when the resting rate normally rises. If you want to use the number for training rather than screening, the Heart Rate Zones tool turns your resting and maximum rates into training zones.

Taking a reading you can compare

Frequently asked

Is a resting heart rate of 55 too low?

Not for most people. The adult reference range is 60 to 100, but well-trained athletes commonly sit at 40 to 60, and in the Copenhagen Male Study men at 50 or below had the lowest mortality. A slow pulse needs a check if it comes with dizziness, fainting or unusual tiredness, or if you are losing weight or eating very little.

Why does my wearable show a lower number than my manual count?

Wrist devices calculate a daily resting value with a formula of their own; in the large wearable study that value was designed to approximate the pulse lying down just after waking, while a manual count is usually taken sitting up. A gap of a few beats is normal; compare like with like.

Does a higher resting heart rate mean I will die sooner?

It is a marker of risk, not a verdict. Across 46 studies, each 10 beats a minute was associated with a 9 percent higher relative risk of death, meaning 9 percent on top of whatever your own risk already is, and the estimate corrected for publication bias was closer to 4 percent. These are observational data: fitness, sleep, weight and blood pressure are the things you can act on.

How quickly does exercise lower it?

In a review of 191 controlled studies, exercisers lowered their resting rate by 3.3 beats a minute more than controls over a median of 12 weeks at 3 sessions a week. Endurance training and yoga had the clearest effect.

Is it normal for women to have a higher resting heart rate?

Yes. In the 92,457-person wearable study, women had a higher average than men in every age bracket. The reference range of 60 to 100 is the same for both.

Should I worry about a jump of 10 beats for a few days?

Usually it signals something temporary: an infection, dehydration, poor sleep or a hard training day. In the wearable study about 20 percent of people had at least one week with a swing of 10 beats or more. If it persists for more than 2 weeks with no explanation, or comes with symptoms, see a doctor.

Sources

• MedlinePlus Medical Encyclopedia: Pulse · US National Library of Medicine; reference ranges by age, athletes 40 to 60, how to count the pulse
• Zhang, Shen and Qi 2016, CMAJ: Resting heart rate and all-cause and cardiovascular mortality in the general population, a meta-analysis · 46 cohort studies, 1,246,203 participants; full text on PubMed Central
• Jensen et al. 2013, Heart: Elevated resting heart rate, physical fitness and all-cause mortality, a 16-year follow-up in the Copenhagen Male Study · 2,798 men, 1,082 deaths, adjusted for measured fitness
• Quer et al. 2020, PLOS ONE: Inter- and intraindividual variability in daily resting heart rate, a cohort study of 92,457 adults · Wearable data, nearly 33 million daily values, United States
• Reimers, Knapp and Reimers 2018, Journal of Clinical Medicine: Effects of exercise on the resting heart rate, a systematic review and meta-analysis · 191 controlled studies, 12,952 participants; full text on PubMed Central

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This guide is for general information. It does not replace medical advice or an examination.