From the Guidelines
A normal resting heart rate for adults typically ranges from 60 to 100 beats per minute. This range represents the number of times your heart beats when you are at rest, such as when sitting or lying down and feeling calm and relaxed. According to the 2019 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay 1, bradycardia is defined as a heart rate <60 bpm in adults, except for well-trained athletes. Athletes and people who engage in regular cardiovascular exercise often have lower resting heart rates, sometimes between 40 to 60 beats per minute, which is considered normal for them due to their stronger, more efficient hearts.
Key Factors Influencing Resting Heart Rate
- Age: Children tend to have higher resting heart rates than adults, with normal ranges varying by age
- Fitness level: Regular exercise can lower resting heart rate
- Body position: Resting heart rate can be influenced by body position
- Emotions: Stress and anxiety can increase resting heart rate
- Medications: Certain medications can affect resting heart rate
- Underlying health conditions: Certain medical conditions can influence resting heart rate It's essential to note that consistently high or low readings outside these ranges may warrant medical attention, especially if accompanied by symptoms like dizziness, shortness of breath, or chest pain. The definition of a normal resting heart rate is based on the most recent and highest quality study available, which is the 2019 ACC/AHA/HRS guideline 1.
From the Research
Normal Range of Resting Heart Rate
The normal range of resting heart rate varies by age and gender. According to a study published in 2011 2, the mean resting heart rate (RPR) is:
- 129 beats per minute (bpm) at less than age 1 year
- 96 bpm by age 5
- 78 bpm in early adolescence
- 72 bpm in adulthood, with a plateau in early adulthood for males and later in middle age for females
Factors Affecting Resting Heart Rate
Several factors can affect resting heart rate, including:
- Age: RPR is inversely associated with age 2
- Gender: There is a significant gender difference, with male pulse rate plateauing in early adulthood and female resting pulse plateauing later in middle age 2
- Ethnicity: Non-Hispanic black males have a significantly lower mean RPR than non-Hispanic white males and Mexican-American males 2
- Medical conditions: Certain medical conditions, such as hyperkalaemia, calcium channel blocker toxicity, and beta adrenergic receptor blocker toxicity, can cause bradycardias 3
Definition of Tachycardia and Bradycardia
Tachycardia is defined as a resting heart rate of 100 bpm or higher, while bradycardia is defined as a resting heart rate of less than 60 bpm 2, 3. However, some studies suggest that a resting heart rate above 60 bpm may be associated with increased risk of cardiovascular and all-cause mortality 4, 5.
Clinical Significance of Resting Heart Rate
Resting heart rate is an important prognostic factor and potential therapeutic target 4, 5. A high resting heart rate has been shown to be independently associated with increased risk of all-cause and cardiovascular mortality 4, 6, 5. Therefore, it is essential to consider resting heart rate as a vital clinical sign that should be measured and evaluated at all clinical visits 5.