Which resting heart rate is dangerous: what is normal, the warning signs and what large studies find

In this article, you can read which resting heart rate counts as normal, which signs mean you should call a doctor straight away, and what large studies find about a resting heart rate that stays high or low for years, all with one question behind it: what resting heart rate is dangerous? That matters, because one number on its own says little. The same value can be perfectly ordinary for one person and a reason to see the GP for another, depending on what is usual for that person and on what else that person feels.⁠^5,6 The BioProfile heart and vascular scan gives you an indication of where you stand today when it comes to your heart and blood vessels. The scan is not a diagnosis. It is insight: it shows where you stand today and can help you make better choices in your diet and lifestyle. Only a doctor can judge what your heart rate means for you.

What a normal resting heart rate is

Thuisarts, the public website of Dutch GPs, says your heart normally beats 60 to 90 times per minute when you are sitting quietly.⁠¹ The Hartstichting gives a guideline of 60 to 100 beats per minute at rest for adults.⁠² You can read more about the reference values on the page about a normal heart rate.

How much people differ from each other was measured in 92,457 American adults who wore a wrist tracker for at least 35 weeks, together almost 33 million daily values. The average resting heart rate was 65. Personal averages ranged from 40 to 109 beats per minute, so one person’s normal value can differ from another’s by almost 70 beats. Each person’s own value was much more stable, although one in five had at least one week in which that value shifted by 10 beats or more. Resting heart rate also differed with age, sex, BMI and sleep, and was lowest in July and highest in January.⁠⁵

For you, this means your own usual value tells you more than a comparison with someone else. In a large study, one in five people had at least one week in which their resting heart rate varied by 10 beats per minute or more.⁠⁵ The sources give no separate guideline for a 70-year-old. In an American study of 6,733 adults aged 45 to 84 with no cardiovascular disease at the start, with an average age of 62, the average resting heart rate was 63 among the 5,831 people who were not taking medicines that change the heart rate.⁠⁴

Which resting heart rate is dangerous: when to call a doctor straight away

Thuisarts advises you to call your GP or the out-of-hours GP service straight away if you have palpitations together with one or more of these symptoms:⁠¹

• pain or pressure in your chest that has not gone after a few minutes
• confusion, difficulty speaking, worse vision or a drooping mouth
• a restless feeling with nausea and sweating, while you turn pale
• difficulty breathing
• the feeling that you are going to faint
• your heart suddenly beats differently from normal, and it does not settle after you have sat quietly for a while

In these situations, the symptoms are the signal, whatever number your watch shows.⁠¹

A high resting heart rate

A resting heart rate above 100 beats per minute is called tachycardia. The Hartstichting advises making an appointment with your GP in three cases: you have a high resting heart rate with no clear cause, you often notice that your heart rate is high and does not fit the situation, or your heart rate rises very quickly with little effort.⁠²

Large studies have looked at what a higher resting heart rate means over many years. One analysis pooled 46 studies with more than 1.2 million people. The risk of dying from any cause rose step by step with every 10 extra beats per minute at rest. People above 80 beats had a clearly higher risk of dying than people in the lowest group, and the higher risk of dying from cardiovascular disease was clearest from 90 beats. That held after the researchers had taken the usual risk factors for cardiovascular disease into account.⁠³ A second review of 87 studies found the same rising pattern for cardiovascular disease, heart failure, coronary heart disease, stroke and sudden cardiac death.⁠⁷

In Copenhagen, researchers followed 2,798 healthy middle-aged men for 16 years. Men with a resting heart rate above 90 had about three times the risk of dying as men with a rate of 50 or lower. That held true after the researchers had taken into account the men’s measured fitness and how active they were in their free time.⁠⁸ So fitness alone does not explain the link.⁠⁸ To find out what sitting still does to your body in other ways, read what too little exercise does to your body.

The Dutch Rotterdam Studie followed 4,768 people aged 55 and over for almost 15 years, and 656 of them developed heart failure. In men, a higher resting heart rate was a risk factor in its own right, and the risk rose with every 10 extra beats. In women, the study found no clear link.⁠⁹ Which heart symptoms women notice is a separate question, covered in heart symptoms in women.

What this means for you: these studies show risk across large groups and many years. A resting heart rate that stays high is a reason to look at it with your GP.⁠² A single reading usually tells you little, unless it falls far outside the expected range.⁠⁵

A low resting heart rate

A heart rate below 60 is called bradycardia, and during sleep the heart rate can drop below 50. For well-trained athletes, a heart rate below 60 is no problem at all, and even without intensive exercise a low resting heart rate can be normal.⁠⁶

In the American study, 5.3 per cent of the 5,831 people who were not taking medicines that change the heart rate had a resting heart rate below 50, compared with 11.2 per cent of the 902 people who were. In people who were not taking medicines that change the heart rate, a heart rate below 50 meant no extra cardiovascular disease and no higher risk of dying over 10 years. In the 902 people who were taking such medicines, a heart rate below 50 meant more than twice the risk of dying.⁠⁴ Atrial fibrillation, a heart rhythm disorder, followed a different pattern. For atrial fibrillation, the review found some evidence of a slight J-shaped relationship, so the pattern differed from the other outcomes.⁠⁷

In short: a low number without symptoms and without medicines is usually no cause for concern.⁠^6,4 Medicines and symptoms change that. Make an appointment with your GP if you often have symptoms with a low heart rate, or if your heart rate does not go up when you exert yourself or feel emotional.⁠⁶

What you can track yourself

Your resting heart rate is a number you can track yourself. Measure your heart rate while you are sitting quietly, the situation in which Thuisarts gives the normal values.⁠¹ Compare the result with your own usual value rather than with someone else’s, because personal normal values differ so much.⁠⁵ The heart and vascular scan adds an indication of where you stand today. It is self-insight. It is not a diagnosis, and the scan does not tell you why your heart rate is high or low. Only a doctor can judge that.

In summary

For adults, a resting heart rate of 60 to 90 or 60 to 100 counts as normal, and personal values vary widely.⁠^1,2,5 Call your GP straight away if you have palpitations along with the symptoms Thuisarts lists.⁠¹ In large studies, a resting heart rate that stayed high for years meant more risk.⁠³ A low resting heart rate without symptoms or medication usually did not.⁠⁴ The scan gives you insight into where you stand today.