Listen to Your Heart: Recognizing When Your Heart Rate Signals Trouble

In today’s fast-paced world, it’s quite easy to overlook the signals our bodies send us, especially when it comes to our heart rate. That must never be the case, as paying attention to changes in the heart rate can be crucial in identifying potential health issues at an early stage. To help the readers keep a close check on their heart health, in this article, we’ll explore how understanding and interpreting changes in heart rate can help us recognize when our cardiovascular health may be at risk. Let’s begin with some basics.

What is Considered a Dangerous Heart Rate?

A dangerous heart rate can vary depending on individual factors such as age, overall health, and fitness level. In general, a heart rate that is consistently outside of the normal range for an individual’s age and activity level may indicate an underlying health concern.

For adults at rest, a heart rate above 100 beats per minute (bpm) may be considered elevated (tachycardia), while a heart rate below 60 bpm may be considered abnormally low (bradycardia). However, context is important, as factors such as stress, anxiety, physical activity, and certain medications can influence heart rate.

In some cases, a heart rate that is consistently elevated or irregular may be a sign of an underlying heart condition, such as atrial fibrillation, ventricular tachycardia, or other arrhythmias. These conditions may increase the risk of complications such as stroke, heart failure, or sudden cardiac arrest.

What are the Normal Heart Rate Ranges?

The normal heart rate ranges can vary depending on factors such as age, fitness level, and overall health. In general, the following heart rate ranges are considered normal for adults at rest:

• Resting Heart Rate (RHR): The average resting heart rate for adults is typically between 60 and 100 beats per minute (bpm). However, some individuals, particularly athletes or individuals who are highly physically active, may have resting heart rates below 60 bpm, which is also considered normal for them.
• Maximum Heart Rate (MHR): The maximum heart rate is the highest heart rate an individual can achieve during intense physical activity. It is estimated using the formula: 220 – age. For example, for a 30-year-old adult, the estimated maximum heart rate would be 190 bpm (220 – 30). However, individual variations exist, and this formula provides a rough estimate.
• Target Heart Rate Zone: During exercise, it’s often recommended to aim for a target heart rate zone, which is typically a percentage range of the maximum heart rate. For moderate-intensity exercise, the target heart rate is usually 50-70% of the maximum heart rate, while for vigorous-intensity exercise, it’s typically 70-85% of the maximum heart rate.

Note: These are general guidelines and individual heart rate ranges may vary. Factors such as medications, stress, caffeine intake, and medical conditions can influence heart rate.

Normal Resting Heart Rates by Age

• Newborns (0 to 1 month): 70 to 190 beats per minute (bpm)
• Infants (1 to 11 months): 80 to 160 bpm
• Toddlers (1 to 2 years): 70 to 150 bpm
• Preschoolers (3 to 5 years): 70 to 130 bpm
• Children (6 to 12 years): 65 to 110 bpm
• Adolescents (13 to 19 years): 60 to 100 bpm
• Adults (20 and older): 60 to 100 bpm

What Factors can Affect the Heart Rate?

Several factors can affect heart rate, including:

• Physical activity: Physical activity and exercise can increase heart rate as the body requires more oxygen-rich blood to be delivered to working muscles.
• Emotional stress: Emotional stress, anxiety, fear, or excitement can stimulate the release of adrenaline, which can increase heart rate.
• Temperature: Both extreme heat and cold can affect heart rate. In hot temperatures, the body may increase heart rate to help regulate body temperature through sweating and heat dissipation. In cold temperatures, heart rate may increase to maintain body warmth and circulation to vital organs.
• Medications: Certain medications, such as beta-blockers, stimulants, decongestants, and asthma medications, can affect heart rate by either increasing or decreasing it.
• Alcohol: Alcohol consumption can cause a temporary increase in heart rate as it dilates blood vessels and increases blood flow.
• Caffeine and stimulants: Caffeine and other stimulants found in coffee, tea, energy drinks, and some medications can increase heart rate by stimulating the nervous system.
• Nicotine: Smoking and nicotine-containing products can increase heart rate and blood pressure by stimulating the release of adrenaline and constricting blood vessels.
• Age: Resting heart rate tends to decrease with age due to changes in cardiovascular function and overall fitness level.
• Fitness level: Regular exercise and physical fitness can lead to a lower resting heart rate, as the heart becomes more efficient at pumping blood.
• Medical conditions: Certain medical conditions, such as heart disease, thyroid disorders, electrolyte imbalances, and autonomic nervous system disorders, can affect heart rate.
• Hormonal changes: Hormonal changes, such as those occurring during menstruation, pregnancy, or menopause, can influence heart rate.
• Hydration and blood volume: Dehydration and changes in blood volume can affect heart rate by altering the body’s ability to maintain adequate blood flow and circulation.

It’s important to monitor heart rate regularly and be aware of factors that can affect it. Significant changes in heart rate, especially if accompanied by symptoms such as chest pain, shortness of breath, dizziness, or fainting, should be evaluated by a healthcare professional.

How to Measure Your Heart Rate?

There are several methods to measure your heart rate, both manually and using devices. Here are some common ways:

• Manual pulse check: You can manually check your pulse by placing your index and middle fingers on the radial artery on the thumb side of your wrist or on the carotid artery on the side of your neck, just below the jawline. Count the number of beats you feel in 15 seconds and multiply by 4 to get your heart rate in beats per minute (bpm).
• Wearable heart rate monitors: Wearable devices such as fitness trackers, smartwatches, and chest straps are equipped with sensors that can measure your heart rate continuously throughout the day. Many of these devices also provide real-time heart rate data during exercise and other activities.
• Smartphone apps: There are several smartphone apps available that use the device’s camera and flash to detect changes in blood flow and calculate heart rate. These apps typically require you to place your fingertip over the camera lens for a few seconds while the app measures your pulse.
• Blood pressure monitor: Some automatic blood pressure monitors also include a built-in heart rate monitor. Simply follow the instructions for measuring blood pressure, and the device will display your heart rate along with your blood pressure readings.
• ECG/EKG devices: Electrocardiogram (ECG or EKG) devices are medical-grade devices that measure the electrical activity of the heart. These devices are typically used in clinical settings but are also available for home use. They provide highly accurate heart rate measurements and can detect abnormalities in heart rhythm.
• Pulse oximeter: A pulse oximeter is a small device that clips onto your fingertip and measures the oxygen saturation of your blood as well as your heart rate. It uses light sensors to detect changes in blood volume and calculate heart rate.

Regardless of the method you choose, it’s important to measure your heart rate at rest and under similar conditions each time for accuracy. If you have concerns about your heart rate or experience symptoms such as chest pain, shortness of breath, dizziness, or fainting, it’s important to consult with a healthcare professional for evaluation and guidance.

How to Lower Your Resting Heart Rate?

Lowering your resting heart rate can have significant benefits for your cardiovascular health and overall well-being. Here are some strategies to help lower your resting heart rate:

• Exercise regularly: Engage in regular aerobic exercise such as walking, jogging, cycling, swimming, or dancing. Aim for at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week. This can improve cardiovascular fitness, strengthen the heart muscle, and lower resting heart rate over time.
• Strength training: Incorporate strength training exercises into your fitness routine to build muscle mass and improve overall cardiovascular health. Strength training can also help increase metabolism and lower resting heart rate.
• Relaxation techniques: Practice stress-reduction techniques such as deep breathing, meditation, yoga, tai chi, progressive muscle relaxation, or mindfulness exercises. These techniques can help promote relaxation, reduce stress hormones, and lower heart rate.
• Maintain a healthy weight: Aim for a healthy weight by following a balanced diet and engaging in regular physical activity. Excess weight, especially around the abdomen, can put strain on the heart and lead to an elevated resting heart rate.
• Limit caffeine and stimulants: Reduce consumption of caffeine-containing beverages such as coffee, tea, and energy drinks, as well as other stimulants such as nicotine. These substances can increase heart rate and contribute to elevated resting heart rate.
• Stay hydrated: Drink plenty of water throughout the day to stay hydrated. Dehydration can lead to an increase in heart rate, so it’s important to maintain adequate fluid intake.
• Get enough sleep: Aim for 7-9 hours of quality sleep per night. Poor sleep quality or insufficient sleep can lead to increased stress hormones and elevated resting heart rate.
• Limit alcohol intake: Limit alcohol consumption, as excessive alcohol intake can increase heart rate and have negative effects on cardiovascular health.
• Quit smoking: If you smoke, consider quitting smoking to improve heart health and lower resting heart rate. Smoking and nicotine-containing products can increase heart rate and contribute to cardiovascular disease.

What Causes a Low Resting Heart Rate?

A low resting heart rate, also known as bradycardia, can be caused by various factors, including:

• Athletic training: Athletes, particularly endurance athletes such as runners, cyclists, and swimmers, often have lower resting heart rates due to their high level of cardiovascular fitness. Regular exercise can lead to changes in the heart’s structure and function, resulting in a more efficient heart that pumps blood with fewer beats per minute.
• Age: As people age, their resting heart rate tends to decrease. This is partly due to changes in the heart’s conduction system and electrical activity, as well as changes in overall cardiovascular health.
• Certain medications: Certain medications, such as beta-blockers, calcium channel blockers, and some antiarrhythmic medications, can slow down the heart rate as a side effect. These medications are commonly used to treat conditions such as high blood pressure, heart rhythm disorders, and angina.
• Certain medical conditions: Certain medical conditions can cause bradycardia by disrupting the heart’s electrical system or reducing its ability to generate or conduct electrical impulses. These conditions may include:
  • Sick sinus syndrome: A group of heart rhythm disorders characterized by abnormal electrical activity in the sinus node, the heart’s natural pacemaker.
  • Heart block: A condition in which the electrical signals that control the heartbeat are partially or completely blocked as they travel from the upper chambers (atria) to the lower chambers (ventricles) of the heart.
  • Hypothyroidism: A condition in which the thyroid gland does not produce enough thyroid hormones, which can slow down metabolism and heart rate.
  • Electrolyte imbalances: Abnormal levels of potassium, calcium, or magnesium in the blood can affect the heart’s electrical activity and lead to bradycardia.
  • Bradycardia-tachycardia syndrome: A condition characterized by episodes of both slow and fast heart rates, often due to malfunctioning of the heart’s electrical system.
• Sleep: During sleep, especially during deep sleep stages, heart rate tends to naturally decrease. This is part of the body’s natural physiological response to relaxation and restorative sleep.

If you have a consistently low resting heart rate or experience symptoms such as dizziness, fatigue, fainting, or shortness of breath, it’s important to consult with a healthcare professional for evaluation and guidance. Bradycardia can sometimes indicate an underlying medical condition that requires treatment.

Is there a Difference Between Heart Rate and Pulse?

Heart rate and pulse rate both measure the frequency of heartbeats, but heart rate refers specifically to the number of heartbeats per minute, while pulse rate refers to the pulsations felt at peripheral arteries. They are often used interchangeably, but pulse rate is the more practical measurement for non-invasive assessment of heart rate.

What are the Different Ways to Feel Your Pulse?

There are several different ways to feel your pulse, each corresponding to different arteries in the body. The most common pulse points are:

• Radial pulse: Located on the wrist, on the thumb side, below the base of the thumb. To measure the radial pulse, place your index and middle fingers lightly over the radial artery and apply gentle pressure. This is one of the most accessible pulse points and is often used for quick pulse checks.
• Carotid pulse: Found on the side of the neck, just below the jawline, alongside the windpipe (trachea). To measure the carotid pulse, gently press your index and middle fingers against the side of your neck, taking care not to press too hard on the carotid artery. The carotid pulse is often used in emergency situations to quickly assess circulation.
• Brachial pulse: Located on the inside of the upper arm, midway between the shoulder and elbow. This pulse point is commonly used during blood pressure measurements and when assessing pulse in infants and young children.
• Femoral pulse: Found in the groin area, midway between the pubic bone and the top of the thigh. To feel the femoral pulse, place your index and middle fingers on the crease where the leg meets the abdomen, just below the inguinal ligament. The femoral pulse is important in emergency situations and when assessing circulation to the lower extremities.
• Dorsalis pedis pulse: Located on the top of the foot, between the big toe and the second toe. To feel the dorsalis pedis pulse, place your index and middle fingers on the top of the foot, just below the ankle joint. This pulse point is often used to assess circulation in the feet and lower extremities.

Knowing how to feel your pulse and understanding its significance can help you monitor your cardiovascular health and detect potential problems early.

Why Does Heart Rate Vary Between Men and Women?

Heart rate can vary between men and women due to several factors, including physiological differences, hormonal influences, and cardiovascular health:

• Physiological differences: Men and women have differences in cardiovascular anatomy and physiology that can affect heart rate. For example, women typically have smaller hearts and blood vessels than men, which may lead to differences in heart rate regulation and response to physical activity.
• Hormonal influences: Hormonal fluctuations, particularly those related to the menstrual cycle and menopause, can affect heart rate in women. During certain phases of the menstrual cycle, such as ovulation, progesterone levels increase, which can lead to a slight increase in heart rate. Hormonal changes associated with menopause can also affect heart rate and cardiovascular health in women.
• Physical fitness: Differences in physical fitness levels between men and women can influence resting heart rate and heart rate response to exercise. Generally, men tend to have higher levels of muscle mass and lower levels of body fat than women, which can result in differences in cardiovascular fitness and heart rate.
• Age: Heart rate tends to decrease with age in both men and women. However, hormonal changes associated with menopause can affect heart rate variability and cardiovascular health in older women.
• Cardiovascular health: Differences in cardiovascular risk factors, such as blood pressure, cholesterol levels, and presence of heart disease, can also contribute to variations in heart rate between men and women. For example, women are more likely to develop certain types of heart disease, such as coronary microvascular disease, which can affect heart rate regulation.

It’s important to note that while there may be differences in average heart rate between men and women, individual variations exist within each gender.

When to See a Doctor for a High or Low Heart Rate?

It’s important to seek medical attention if you experience persistent high or low heart rates, especially if accompanied by symptoms or underlying health conditions. Here are some guidelines for when to see a doctor for high or low heart rate:

High Heart Rate (Tachycardia)

• Persistent tachycardia: If you consistently have a resting heart rate above 100 beats per minute (bpm) or experience episodes of rapid heart rate (such as palpitations) that last for an extended period of time, it’s important to consult with a healthcare professional.
• Symptoms: If you experience symptoms such as palpitations, chest pain, shortness of breath, dizziness, fainting, or fatigue along with a high heart rate, seek medical attention promptly.
• Underlying health conditions: If you have a known heart condition, such as arrhythmias, heart disease, or thyroid disorders, and experience changes in heart rate, it’s important to follow up with your healthcare provider for evaluation and management.
• Medication side effects: If you are taking medications that may increase heart rate as a side effect (such as stimulants, decongestants, or certain medications for asthma or depression), consult with your healthcare provider if you have concerns or experience symptoms.

Low heart rate (Bradycardia)

• Persistent bradycardia: If you consistently have a resting heart rate below 60 beats per minute (bpm) or experience episodes of slow heart rate (such as lightheadedness or fainting) that last for an extended period of time, it’s important to consult with a healthcare professional.
• Symptoms: If you experience symptoms such as dizziness, lightheadedness, fainting, weakness, fatigue, shortness of breath, chest pain, or confusion along with a low heart rate, seek medical attention promptly.
• Underlying health conditions: If you have a known heart condition, such as sick sinus syndrome, heart block, or electrolyte imbalances, and experience changes in heart rate, it’s important to follow up with your healthcare provider for evaluation and management.
• Medication side effects: If you are taking medications that may decrease heart rate as a side effect (such as beta-blockers, calcium channel blockers, or certain antiarrhythmic medications), consult with your healthcare provider if you have concerns or experience symptoms.

Final words

If you’re experiencing concerns about your heart rate or have noticed any unusual symptoms, it’s essential not to delay seeking professional medical advice. Dr. Lingaraj Nath,  Sr. Consultant Interventional Cardiology & Director Cardiology at Manipal Hospitals is dedicated to providing comprehensive cardiac care and personalized treatment plans tailored to your specific needs.