Ask the Doctors 10/10

Dear Doctors: My heart rate was 99 when I went for my physical recently, and my doctor said that’s too high. I explained it’s usually about 80, but medical appointments make me nervous. Still, it got me to thinking: What’s a normal resting heart rate? How do I get it to be lower?

Dear Reader: Heart rate refers to how many times your heart beats each minute. Add in the word “resting,” and you’re talking about a heart rate measured when someone is calm and relaxed. Along with blood pressure, it’s an individual’s resting heart rate is often considered to be a window on their general health. And, just so you know, it’s not that unusual for someone’s heart rate, along with their blood pressure, to become elevated in the sometimes-stressful setting of a medical office.

According to the American Heart Association, a resting heart rate that ranges from 60 to 100 beats per minute is normal for an adult. Factors such as age, gender, height, weight, physical fitness, lifestyle and general health each play a role in a person’s resting heart rate. Cigarette smoking often elevates heart rate. So can stress, depression or being sick with a cold or the flu.

Elite athletes and people who are physically fit tend to have lower resting heart rates, sometimes measuring in the 40s or 50s. Medications can have an effect on heart rate, as well. For example, stimulants such as Ritalin and certain antidepressants have been shown to raise resting heart rate. Other drugs such as calcium channel blockers or beta blockers can slow the heart rate down. Some studies have associated a rise in resting heart rate with an increased risk of complications such as atrial fibrillation or coronary artery disease.

Although resting heart rates vary widely from person to person, for each individual they tend to remain fairly stable over time. If you should notice a sudden and lasting change, check in with your doctor. Becoming familiar with your heart rate, and how it changes when you’re relaxed and when you’re active, can help you stay aware of your own general health. Start by measuring your heart rate before you get out of bed in the morning. Just locate the pulse point on your wrist, count the number of beats for 30 seconds and multiply by two. Repeat the process throughout the day, during various activities and while at rest, and you’ll develop a sense of how your heart behaves.

One of the best ways to a lower resting heart rate is through physical activity. A 2018 analysis of studies on the topic found that exercises that build endurance, as well as yoga, had a beneficial effect on resting heart rate. Deep breathing and meditation are also helpful. Substances like caffeine, nicotine and sugar all increase heart rate, so be aware of what you ingest.

As with all types of change, be realistic. Start slowly and gradually build toward a goal so you’re in control and stay safe.

Send your questions to askthedoctors@mednet.ucla.edu.