What is too high a heart rate: at rest, during exercise and in children, and when to call your GP

In this article, you can read which resting heart rate is normal and what a higher resting heart rate goes together with. You can also read how high your heart rate can go during exercise, what is normal for a child and which signs mean you should call your GP. This matters, because a number on your watch, or a heart that pounds while you are sitting on the sofa, can quickly make you worried and is hard to judge. The same number of beats can be normal for one person and unusual for another.⁠⁴ The BioProfile heart and blood vessel scan gives you an indication of where you stand in this area today. The scan is not a diagnosis. It gives you insight into where you stand today, to help you make better choices in your diet and lifestyle. The scan does not tell you what is causing a fast heart rate, or whether you have a heart rhythm disorder. Only a doctor can tell you that.

How high can your resting heart rate be?

Thuisarts, the public website of Dutch GPs, says the heart normally beats between 60 and 90 times a minute when you are sitting quietly.⁠¹

People differ a great deal. A study in the United States followed 92,457 adults who wore a wrist heart rate monitor for at least 35 weeks. Their average daily resting heart rate was 65 beats per minute. The participants’ own averages ranged from 40 to 109 beats per minute. What is normal for one person can differ by up to 70 beats per minute from what is normal for someone else. For most participants, heart rate stayed fairly stable in the short term: it was lowest in July and highest in January, and one in five people had at least one week in which it changed by 10 beats or more.⁠⁴

What this means for you: the researchers think measurements taken over a longer period may tell you more than a single measurement, but the study did not show when a change is a reason to see a doctor.⁠⁴

Age plays a part too. The Dutch LifeLines study recorded heart tracings (ECGs) from 152,180 residents aged 18 to 93. Among participants without risk factors for the heart and blood vessels, the typical heart rate was highest in the youngest and the oldest.⁠⁵ So a somewhat faster heart rate is common at both ends of adult life. You can read more about what counts as normal on our page on a normal heart rate.

What a higher resting heart rate means over the years

One analysis brought together 46 long-term studies in the general population. More than 1.2 million people were included for death from any cause, and almost 850,000 for death from heart and blood vessel disease. The higher the resting heart rate, the higher the risk of dying in the years that people were followed, and the risk rose slightly with every 10 extra beats per minute. People with a resting heart rate above 80 had a clearly higher risk than people in the lowest group, both of death from any cause and of death from heart and blood vessel disease. The researchers add that the studies differed widely from one another, and that some results may never have been published.⁠²

What this means for you: Thuisarts calls 60 to 90 normal when you are sitting quietly,⁠¹ but people in the group with a resting heart rate above 80 had, on average, a somewhat higher risk over many years. This is a pattern in large groups of people. The pattern says nothing about what your own heart rate means, and judging that is a job for a doctor.⁠² To read what a lot of sitting still does to the rest of your body, see what too little movement does to your body.

How high can your heart rate go during exercise?

During exercise, your heart rate can rise far above its resting values, and how far depends mainly on your age. One study brought together 351 earlier studies with 18,712 people and then tested the result in a lab test with 514 healthy adults. According to that study, the maximum heart rate of a healthy adult is about 208 minus 0.7 times their age. The rule was the same for men and women, and did not depend on how much people usually moved. The well-known rule of 220 minus your age underestimated the maximum for older adults.⁠³

In practice: for someone aged 60, the newer rule gives about 166 beats per minute, while 220 minus age gives 160. Both are estimates based on age alone.⁠³

What is a normal heart rate for a child?

Children’s hearts beat faster than adults’ hearts. One review of 69 studies covered 143,346 healthy children from birth to 18 years. The typical heart rate was 127 beats per minute at birth, rose to 145 at the age of about one month and fell to 113 by the age of two. The review also found that published normal values for children often did not match these figures.⁠⁶

So a heart rate that would be fast for an adult can be normal for a baby or a toddler. Compare a child’s heart rate with the figures for that age, not with the values for an adult.⁠⁶

When a fast heart rate comes from your heart rhythm

A fast resting heart rate can also come from a problem with the heart’s rhythm. Atrial fibrillation is a rhythm disorder that has been counted in Dutch studies. In LifeLines, atrial fibrillation or atrial flutter showed up on the ECGs of 0.9 per cent of adults. Extra beats from the atria showed up in 1.4 per cent, and extra beats from the ventricles in 2.1 per cent.⁠⁵

Atrial fibrillation becomes more common with age. In the Rotterdam Study among residents aged 55 and over, 5.5 per cent had atrial fibrillation: 0.7 per cent of people aged 55 to 59 and 17.8 per cent of people aged 85 and over. Men had it more often than women, and at 55 the chance of developing it at some point in life was nearly one in four for both.⁠⁷

What this means for you: heart rhythm disorders are common, especially over the age of 55. Heart rhythm disorders can show up on an ECG.⁠⁵ Whether your rhythm is irregular is something a doctor checks.

When should you call your GP?

Call your GP or the out-of-hours GP service straight away if you have palpitations together with one or more of these signs:⁠¹

• pain or pressure in or on your chest that does not go away after a few minutes
• confusion, difficulty speaking, reduced vision or a drooping mouth
• a restless feeling with nausea, sweating and a pale face
• difficulty breathing
• the feeling that you are going to faint

Also call straight away if your heart suddenly beats differently from normal and this does not settle after you have sat quietly for a while.⁠¹ You can read which heart symptoms women may notice in heart symptoms in women.

What the scan can and cannot tell you

The heart and vascular scan gives you a picture of where you stand today. Your score is a starting value that you can later set beside a new score. The scan does not tell you why a heart beats fast, nor whether the rhythm is irregular. For that, you need a doctor and an ECG.⁠⁵

In summary

When you are sitting quietly, a heart rate of 60 to 90 beats per minute is normal.⁠¹ Your own usual number generally says more than how you compare with someone else.⁠⁴ Over the years, a resting heart rate above 80 goes, on average, with a clearly higher risk.⁠² Your maximum during exercise falls as you get older.⁠³ Children have a faster heart than adults.⁠⁶ Heart rhythm disorders become more common with age.⁠⁷ Palpitations with chest pain, difficulty breathing or a feeling that you might faint are a reason to call your GP straight away.⁠¹