Why Resting Heart Rate Is Important for Health

Heart rate — the number of times the heart beats per minute — would seem to be an obvious variable in health and longevity, especially as it concerns heart disease. True to intuition, it turns out that resting heart rate is important for health.

What resting heart rate means

Resting heart rate (RHR) can be compared to VO2max, in that they both measure a parameter that itself has many facets. RHR measures not just the integrity and health of the heart, but the overall health of the blood and the tissues it oxygenates, as well as the nervous and hormonal systems, which play important roles in setting heart rate.

A good deal of research has looked into the association between RHR and cardiovascular disease — which is the leading cause of death in the U.S. — and also the association with total death rates.

In all cases, the research has found that

  • a low resting heart rate means a low death rate
  • a high resting heart rate means a high death rate

Associations don’t get much easier than this for a test that you can do yourself at home, no expense or doctor’s order required.

Since there’s an abundance of research in this area, let’s just look at one recent study: “Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women”.1

The study was done in Finland. The Finns take a keen interest in heart disease because their country had at one time the world’s highest rate of heart disease.

The subject population consisted of 10, 519 men and 11.334 women, more than enough to generate solid data. Follow-up time for any individual in the study ranged from 6 to 27 years from the time that RHR was measured. Median follow-up time was 12 years.

Subjects who had a previous heart attack, were being treated for high blood pressure, or had heart failure or angina (chest pain) were excluded, so the study was looking at people who showed no signs of heart disease.

When grouped into quintiles (fifths) of resting heart rate, the results  for RHR vs cardiovascular mortality looked like this:

cvd rhr mortality

Keep in mind here that each quintile contains exactly 1/5 of the group, e.g. 1/5 of all men and women had a resting heart rate >82, and only 1/5 had one of <60.

Men in the highest quintile had nearly four times the rate of death from cardiovascular causes as the lowest quintile, and for women about three times.

Next, take a look at the chart for total mortality, that is, death from all causes, not just cardiovascular disease. The same relation holds: the higher the resting heart rate, the greater risk of death.

mortality rhr

For men, those with RHR >82 had about three times the death rate as those with RHR <60. For women, the same relation was about double.

These results were attenuated somewhat after the researchers adjusted their stats for waist size, smoking, blood pressure, diabetes, and physical activity, but remained highly significant, with total mortality increasing about 20% for each increase in RHR of 15 beats per minute, for both men and women.

Why resting heart rate affects health

The researchers comment:

The mechanism through which elevated RHR exerts its deleterious effect is unknown. Possibilities include predisposing to ischemia, arrhythmia, and plaque rupture or by promoting atherogenesis by increasing the absolute number of sheer stresses to which the vessel wall is exposed. Our demonstration of the stronger effect on fatal than nonfatal events supports proarrhythmogenicity as one of the mechanisms, as do previous studies showing a particularly strong effect of elevated RHR on sudden cardiac death. [Link added]

Curiously, although RHR is perhaps most strongly affected by one’s level of physical fitness, the association between RHR and death rates persisted even after adjusting for physical activity.

How to measure your resting heart rate

You can easily measure your resting heart rate.

First, find your pulse, either at your wrist or neck. Count the number of beats in 30 seconds, then multiply by two. This is best done in the morning in a calm state. If you take it at work or within a few hours after exercise, the reading likely won’t be accurate.

I took my RHR yesterday, and it was 46, putting me solidly in the lowest quintile. I wonder whether if the researchers had made their results more finely grained, and broke out the results for, say, those with RHR <50, whether risk would be even lower. My guess is that it would, since all the results in the study were graded, that is, for each rising quintile of RHR, death rates were higher.

In a chart showing what each level of RHR represents, my RHR falls into the category of “athlete” above “excellent”. (note that this chart doesn’t have any scientific references, so take that at face value — or not.)

An article at National Geographic says that a well-trained endurance athlete has a RHR of 40, and that Miguel Indurain, a five-time Tour de France winner, had a RHR of 28.

Back when I used to run long distance, I recorded a RHR of 32.

How to lower your resting heart rate

Besides obvious factors like losing fat and not smoking, the most important way to lower resting heart rate is through exercise.

While endurance exercise may be on record as producing the best results, to my knowledge, other exercise modalities haven’t been look at. For example, what is the Olympic sprinter Usain Bolt’s resting heart rate? Or that of an Olympic weightlifter? my guess is that they are all quite low.

Also, as we’ve previously seen, resistance training, especially when done at high intensity, produces an increase in VO2max, so that works too.

High-intensity interval training is also good for lowering RHR.

The key for lowering RHR is, just as for anything you want to improve, putting a stress on the body. Therefore, exercises like walking, while a healthy pursuit, may not do much to lower RHR; they simply don’t proviode enough stress to the system.

If you don’t already exercise, and want to undertake a program of RHR-lowering exercise, you should get a doctor’s clearance first, especially if you’re older and/or have pre-existing illnesses.

PS: For more on the best exercise, see my book Muscle Up, and for more on anti-aging, see my book Stop the Clock.

PPS: Check out my Supplements Buying Guide for Men.

  1.  Cooney, Marie Therese, et al. “Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women.” American heart journal 159.4 (2010): 612-619.

Leave a Comment:

Why Resting Heart Rate Is Important for Health – Technology and Longevity Feed says August 24, 2016

[…] Original Article: Why Resting Heart Rate Is Important for Health […]

Hansen says August 24, 2016

More data to consider. Ray Peat thinks low heart rate indicates low metabolism and he wants to bring up both heart rate and body temperature , thus speed up the bodies metabolism.

    Bryan says August 25, 2016

    Yup, was going to add as much. In fact, Ray Peat’s proposals counter significant ideas P.D. Mangan promotes, for example sugar being a bad thing and fasting being a good thing. I really don’t know where the truth lies – likely combination of the two. They agree on iron at least!

    It would be great if this blog took a deep dive into the Peat philosophy to see where areas of agreement are.
    Starting points:
    http://www.organizingthepanic.com/ – I suspect a healthy head of hair is a decent proxy for good health (losing hair being associated with aging and environmental, hormonal or chemical shock)

    Drifter says August 25, 2016

    When I took a very high-level look at this a while back, the best conclusion I could come to is that while symptoms of low thyroid are certainly bad, speeding up one’s metabolism to be as fast as possible is almost certain to lead to faster aging. Google “metabolic rate and longevity”. As with so many other things, just because too low is bad, does not mean “as high as possible” is the desirable course. A ‘fast metabolism” has become associated with the health benefits of losing body fat, however this would not have been an issue for most of human history and the last thing a species would have wanted would have been burning fuel unnecessarily.

      P. D. Mangan says August 25, 2016

      Yup. Centenarians are characterized by low thyroid levels and presumably the low metabolisms that go with it.

      Ted says August 26, 2016

      Organizingthepanic has 4 free videos on youtube by Danny Roddy, watching the 2nd now. Very interesting

Josh Mitteldorf says August 24, 2016

My guess is that (at least in part) RHR is a surrogate for aerobic exercise. People who do CV exercise consistently have lower resting heart rates.

Ole says August 24, 2016

According to this study, strenuous joggers had the same mortality rate as sedentary non-joggers. Those with the lowest mortality were the slow joggers. Apparently there seems to be a U-shaped curve for exercise, where moderate exercise is associated with decreased mortality and strenuous exercise with increased mortality. More is not always better:, apparently.


Stefan Sladeček says August 25, 2016

Hinh resting heart rate itself is not so much a risk factor per se, but rather a marker for the presence of underlying CV risk factors.

Therefore, while the presented study itself is of high value, the first sentence “The mechanism through which elevated RHR exerts its deleterious effect is unknown.” is misleading Basically, the heart rate goes up as a compensatory reaction to ill CV health, in order to satisfy the body needs.

But a CV event (stroke, ischemia, heart attack,..) is NOT caused by the high heart rate itself, but by the malfunctions that cause the high heart rate (except when untrained people put too much punctual stress on the heart by over-vigorous exercise and collapse)

FormerlyBigFatGuy says August 25, 2016

Doctors put a pacemaker in my dad because they said his heart rate was too low. According to them, dad was at risk of dying in his sleep. I always suspected that was BS.

John Pollard says August 27, 2016

I have always had a somewhat low resting heart rate. I am currently 65 . My resting heart rate when I wake up in the morning is usually about 45. In my 20’s I once went to the Red Cross to give blood and they told me they could not take my blood because my heart rate was too low – it was less than 40. I told them to come back and measure it in a few minutes. It was then over 40 and they let me give blood. I have been tested for low thyroid levels and that is not my problem. I exercise on a fairly regular basis , but I am by no means an athlete. I can only chalk my low resting heart rate up to genetics.

    P. D. Mangan says August 27, 2016

    When I was quite young, I don’t know, say 7 or 8, my Dad (a doctor) took me to a cardiologist for examination. The upshot was that I was fine, but I never knew why I was taken to see him. I now think my Dad must have discovered that I had a very low resting heart rate.

Vincent says August 27, 2016

Great post! I’m going to measure my resting heart rate and make a goal to drop it as low as I can to a healthy amount. When one is working on lowering their RHR, is their a average drop to look for? For example, with frequent training and good diet, I may lose 2 beats off the number a month?

    P. D. Mangan says August 27, 2016

    Thanks, Vincent, most likely any drop or even absolute amount is highly variable from person to person, depending on genetics, BMI, age, etc.

The Low-Salt Fiasco - Rogue Health and Fitness says June 18, 2017

[…] salt consumption leads to a higher heart rate, which is independently associated with higher mortality. Therefore any benefit from lower blood pressure could be negated by a higher heart […]

Add Your Reply