From the podcast from Dr. John Day (drjohnday.com) , with the title:
"What Should Your Resting Heart Rate Be?
If you consult online with the Mayo Clinic, they will tell you that a normal resting heart rate is 60 to 100 bpm. While this may be a typical resting heart rate, it is certainly not an optimal resting heart rate.
In recent study, researchers enrolled 6,733 mostly middle aged people. Everyone’s resting heart rate was recorded at the beginning of the study. These study participants were then followed closely for 10 years to see who died and who was still alive 10 years later. The results, among other, were:
1. If the resting heart rate was naturally slower than 50 bpm, survival was 29% higher.
2. If the resting heart rate was artificially lowered with medications, to less than 50 bpm, the risk of death was 2.4 times higher.
Common medications that artificially slow the resting heart rate include beta-blockers, calcium channel blockers, digoxin, and anti-arrhythmics. If your heart rate is artificially slowed to less than 50 bpm, please speak with your physician to see if you should be on less heart medications."
Hope, that somebody may find some interest in it...
It’s highly likely that people who are prescribed drugs like beta blockers which slow the HR already had a cardiac condition which put them at higher risk at baseline.
So many factors that feed statistics and few of us fit the “mean” which is just the mid point between them what does and them what don’t. Without a careful study of the research and, more importantly, any follow-up, those figures are quite meaningless - at least they are to my maverick heart and brain! As I see it I’m either going to die before my time or preferably a long while after my time. But the factors influencing age of death are too myriad to count. Interesting point though, and I do enjoy keeping track of my persistent Afib with my new iPhone! (Though rather more boring than if I had PAF)!
PAF may be more interesting but not in a good way. I am going through a very difficult house move and as part of that have clear a loft that is overflowing with stuff that has to be removed and sorted. As I’m not keen on going up on my own my daughter is booked to help with clearance this week. So I’ll only give you one guess what happened on Friday evening. Still going and I get very breathless when I make any effort. 🤬 But I have to keep trying to work because I’ve got a deadline. If I was in persistent/permanent AF I’d have made plans accordingly.
I don’t mean that to be unsympathetic to you though ❤️🩹
Yes, I was being ironic about PAF being “interesting,” I know it’s awful. I only had a couple of episodes of soaring heart rate and it’s scary. Sounds like you’ve got your hands full too. Hope you can take it easy now, particularly in this hot weather!
Yes, I was being ironic about PAF being “interesting,” I know it’s awful. I only had a couple of episodes of soaring heart rate and it’s scary. Sounds like you’ve got your hands full too. Hope you can take it easy now, particularly in this hot weather!
are you sure you meant to say that people with persistent AF can plan their days? Maybe you meant to say asymptomatic persistent AF sufferers.
Because those of us symptomatic persistent AF sufferers are in a little hell of our own and I for one can’t plan any activity of significance on any day with any degree of certainty. I don’t get the beautiful respite of NSR at all, and having had a cardioversion that worked for 3 days I do know what bliss that is.
It’s why people like Mummyluv have gone to such extremes of investigation and surgery to get out of persistent AF.
Basically, your comment just airbrushed people like us out of existence and I felt a little troubled by it.
I’m sorry you’re upset by what I said. As so often said we are all different but perhaps I should have only said permanent which generally seems more tolerable. After a few happy hours in ‘unclassified’ I’ve been in AF ever since, so nearly a week. I’ve been able to carry on with what I have to do with frequent rests and plenty of fluid but no, I wouldn’t want to carry on like this and after a couple of ‘elephant sat on my chest’ episodes I’m off to the GP this morning, taking the advice I dish out to others 🙄 I know there’s nothing immediate she can do but I think it’s time for a moan. If I were a younger person I would certainly look for a way out of symptomatic persistent AF.
I tend to ignore my AF tracking, as it’s a bit depressing being told that my burden is 100%. Finding the original post a little annoying. I’ve always had a low resting heart rate - in the 50s for the last few years, low blood pressure and no other heart conditions. My AFib progressed to persistent very rapidly - although it was likely undetected for quite a few years.
One unsuccessful ablation, too much fibrosis for more procedures - so I need to accept that it’s rate control only. I can’t say that I love being on Bisoprolol, but see it as essential to keep the ventricular rate down while in persistent AFib, particularly when exercising. So, I’m trusting my EP, who feels this is the best thing for me right now. Just pushing on with walking etc.
It doesn’t mean that I’ve been a dreadfully unhealthy person. Some of us are just unlucky with their AFib!
I seem to be on a similar path Gumbie, my AF progressed to persistent very fast. It is bad luck. Like you I was leading a fairly healthy life too, then suddenly the breathlessness and bubbly heart symptoms. I don’t get those awful episodes of high, racing heart that many with PAF get though, so that to be thankful for!
I am lucky not to be bothered by the palpitations, and when in the day ward during diagnosis I was sitting and knitting while the monitor went from 40 to 170. Very lucky not to get breathless - so far - just heavy legs.
In some way fewer symptoms is really lucky, but it does mean delayed diagnosis. It’s such an odd condition, we are all so different!
Probably nothing to do at all with resting heart rate, but due to the fact that people on rate meds vs those who are not, tend to have more health issues I like John Day, but he's a writer and needs space to fill. Would not put a lot of importance into this particular article.
Jim, the quoted sentence is of particular importance. Reduced resting HR (via medication), means reduced BP (wow !!!) and reduced blood flow-rate (poorer supply of all tissues with oxygen, nutrients etc.). Long term, it puts the body in very bad situation, so no wonder people live shorter.
Not convinced it's cause and effect. Could be simply that people who are on these types of meds are in overall worse health than people who are not on them.
That said, where is that sentence from? Do you have the complete transcript or a link to the podcast?
Well I have PAF (symptomatic when episodes arise) but take regular meds (sotalol and apixaban). Normally feel fine in-between episodes, does than mean I am going to die sooner?!
I’d want to know more about the study before jumping to conclusions as well. People with HR naturally below 50 are usually in pretty good shape, often athletes. People on meds that lower HR to below 50 obviously have some reason for taking the meds which may be cause of lower life expectancy vs the drugs. It’s also possible the drugs are causing or contributing to reduced life expectancy. Need more info. That being said, I think it’s reasonable to question whether one is taking more meds than needed if HR is getting low. I am a case in point. Started on metoprolol and flecainide which has managed my afib nicely. My resting hr before drugs was mid to high 50s. After drugs, mid to high 40s. I was VERY TIRED. My PCP talked with cardiologist who agreed to reduce metoprolol (extended release) from 25 mg 2x day to only 1 time a day. Now hr is usually low 50s and I’m definitely less tired. Afib still being managed. Also started on B12 on docs recommendation cause it was on the low side. I think of it as tweaking the meds to find the right balance and I encourage people on meds to discuss that with their MDs cause it’s a challenge finding what works for you.
There’s a lot of misunderstanding as to what “low blood pressure” is. People with a perfectly normal BP of 105/65 (for example) seem to be convinced they have low BP.
I know that patients with eating disorders frequently have low HR and low BP but that’s because their bodies have to adapt to having a very low intake of food in some cases as the body cannot afford to “waste” energy on nothing but essential functions so tries to conserve itself on the minimum energy expenditure. These are not physically healthy people though.
I’m assuming this was a study carried out at population level and therefore cannot be extrapolated to individuals.
What is high BP for someone may be fine for someone else. None of us should feel smug about having a 'low' BP because none of us really know what our ideal BP should be.
People have the BP that they have. It’s determined by their own biology. Some people do have BP at the low end of the normal range and it’s nothing to do with anything the do or don’t do. They don’t take meds or anything. It just is. A BP lower than 90/60 is probably not so good but that’s how it is for some people and low BP is not considered to be a treatable condition. The usual advice is “use more salt”.
Like any pump, the heart will give larger blood flow-rate if the BPM is increased, Sometimes, it is not directly connected - if you go into AF, then pumping efficiency of the heart will be reduced, so, despite increase in BPM, your BP may go down. If you go into ventricular tachycardia, then the pumping efficiency may be still smaller and the blood flow-rate and BP may drop even more, to the limit of blacking out.
As BP lowering drugs, BB are given precisely with the aim to reduce HR and, through this, blood flow-rate.
In most cases, I am not a fan of beta blockers and that is an understatement. I think they can do more harm than good for afib patients who are in normal rhythm. That said, I was just questioning the cause/effect of Day's writing. Thanks for the link and I will try and listen.
Hi, this is an interesting abstract from a paper that provides some raw outcome data from a big sample. In the 1950's statisticians showed a perfect correlation between new washing machine sales and road deaths - it was the starting point for statistical study. Of course it was not cause and effect but there was an underlying relationship about wealth and changing demographics etc.But wanting to know and understand your own data and risks is probably a core reason for sharing stuff on HU.
And on this forum what is more important than thinking about life expectancy as affected by a heart related condition.
A low heart rate can be a proxy for being fit and healthy. It can also be related to sudden death in young super fit people.
In my study group of one, my normal is sinus bradycardia with ectopics. Although overweight I was exercising, and after investigations including the treadmill etc was told to go away, I was fit and healthier than most.
Forward 6 years and benefitting from even more extended cycling exercise I had a stroke 15 months ago. Paroxysmal, no explanation.
Feeling insecure about cycling and being on rural roads 30 Kms or more away from home I looked to feet on the ground exercise and started running using C25K. It's definitely more energetic and demanding than cycling.
12 months on from finishing C25K the exercise regime is still strong. What about the metrics and my study of one. Well my HR is 10% points better, lower, resting, aerobic and anaerobic, with much faster recovery rates. My cardiovascular system, BP etc is significantly improved. And I can run further and faster than that week 1/1 one minute exhausting Brum of C25K. When a recent operation developed complications on the operating table, post surgery I was advised I was helped by my general level of fitness and was able to be discharged earlier.
I think it's safe to say, from my study of one, raising exercise level and mobility will improve people's health whatever level of increase in activity is achieved, ie it doesn't have to be C25K.
Will it increase longevity? In a study of one that's impossible to say. My stroke recovery was a post code lottery. My exercise may have been learning to walk again.
But the heart is a biological machine and it can wear out. It stands to reason if it is beating fast that's it's fundamental unit of wear. If it can do the same amount of work for the vascular system at a slower rate it's more efficient and less stressed. This is the driving logic of cardiovascular medicines I assume.
Many years ago on an Horizon type science programme a scientist has written a paper looking at mammalian heart rates and longevity. A mouse had a very rapid heart rate and is short lived. Humans and whales have relatively slow heart rates and live a long time. The scientist developed a theory that the mammalian heart being fundamentally the same between species had a maximum number of heartbeats in a lifetime!! Slow seemed better, but probably naturally slow being best.
I hope you have enjoyed this read and feel free to comment and point out the flaws!!!
Hi! I have really enjoyed reading your comment! Your study of one is very interesting and very educative! It would be such a good thing if people were willing to share their detailed stories, it would be a precious source if information. But, unfortunately, nowadays people hide the data, even about their gender and age (I understand females, lol).
I see that you are relatively new on this forum, so, please, do not mind my trying to tell you my impressions after, I believe, more than 10 years of reading it. Almost all of us here are or were exercise addicts. I was very active in my young days, so acquired resting HR of 48, which was very stable during my life. I continued exercising up to the age of 60, then stopped. Something from inside told me that it is time to stop, maybe because it was at 55 that I was rewarded with my first arrhythmia, lol. Not much has changed in the past 10 years (I am also 71 yo). I have not gained weight, I can work hard and use every opportunity to do so, but I abandoned exercising.
My impression is that people attribute too much importance to the diet, maybe seeing it as the main way of interacting with the surrounding world, but physical activity has more importance. Among them, cycling and running are the most frequent activities which are later rewarded with some kind of arrhythmia. I still remember the sentence written by a forum member: "Isn't it funny, how many of us here are cyclists!?" No, it is not funny, it is indicative!
My study of one is named "No drugs for me". Despite having AF at night regularly and from time to time being a consumer of some other types of arrhythmia (AFlutter, PVCs), I refuse drugs, anticoagulants included. My BP is also increased, sometimes to serious level (190/120), but I also do not take any BP drugs. I am not suggesting to anyone to do the same, but what's the purpose of life if we do not research and go forward. At least, it may be interesting for others to see that it is possible to be without drugs (where were all the drugs only 50 years ago!?). If I die prematurely because of it, I promise to report, lol!
I like your post and you make some interesting points as do those above who have replied to your initial entry.I have just listened to the john day podcast. It was well balanced He makes the point that most mammals have the potential for about 3 billion heartbeats in one lifetime. This gives a potential life expectancy of 93 years if we take heartbeats to be the sole determinant of lifespan. I have often heard people give a mechanical explanation for the functioning of the heart and other body systems. We are of course biomechanical and cells can regenerate.
A good diet and regular exercise can help in this process. You can the optimise your health within your own individual circumstances. You can change your trajectory and increase your longevity supported by a functional heart.
I have the impression that you are strong spirited with a high degree of self agency, which is good and healthy.
I would disagree with your point that nutrition/diet is over emphasised as a contributor to good heath.
Good luck with your journey.I do hope that your decision to not take meds works in your favour.
Hi Peter, I'm definitely with you on thinking maybe too many drugs are prescribed and the nature of trials tends to lead to population innoculation because that is the nature of epidemiology. EDOXABAN is the latest example with NICE guidance targeting 600000 users over the next two years to save an estimated 6500 lives, and prevent 20000+ strokes. It also legitimises the confidential pricing policy to the NHS with the drug company, a big figure no doubt.But I'm exceptionally grateful for the shot of thrombolysing drug, the MRI imaging and CT scans I received, on Sunday March13th at around 11.45 am! And of course all the science and probability statistics behind it. I also remember the sombre faces, the shaking nervous hands of the paramedics, the attendant risks of trying to do something and the almost certainty of a massively altered life doing nothing before the dose was administered. And of course my body as life started ebbing away from that clot in my mid cerebral artery. When all that was left was a determination to stay awake.
I'm completely new to running and monitoring exercise, well, 12 months in. I stick with the C25K mantra of #ianodatruffe sadly late of HU, 'always at a conversational pace'. I am passionate about Parkrun for all its non running health benefits too. Moderation in all things.
I find health unlocked works best for me when genuinely informative and the experiences shared are genuinely owned and authentic. Hence my interest in what you have shared. I was on HU after my stroke trying to find some reassurance and understanding of such a traumatic event out of the blue. I think I exhausted what I could find or offer so made space for other newbies. At the time HU C25K was brilliant. It offered hope - a real intangible.
This time around I now have a single episode of possible AF or A flutter identified and a change of drug regime so some new things to learn or be aware of. I've learnt a new word from a HU post, claudication, which is maybe helpful to understand some side effects I'm experiencing and to monitor the actual individual impact against the population gains of taking EDOXABAN.
Thanks again for enabling these thoughts to be put to digital history! Cheers Nigel
Interesting. My cardiologist has just written to my GP suggesting that she puts me on either beta blockers or dronedarone for frequent PVCs. From everything that I've read, I'm nervous about this because my resting heart rate is around 58. But I do need to reduce the PVCs as the frequency and breathlessness impacts my life.
Thanks for taking time to reply! We are very often bound to numbers, (HR, BP etc.), but they are only for orientation. What matters, is how you feel. Your body will always tell you if you (or the GP that has prescribed the drug) are making the mistake. So, simply correct it... All the best!
Interesting comments, last time I saw my cardiologist my meds were altered as he likes his patients HR to be around 70. Must admit I feel much better, less tired and breathless, which has resulted in me walking more and returning to seated yoga. I've got DCM too. Never been a gym bunny but used to dance and in later years learnt to sail and I've done yoga for 30 years so am still flexible.
Thanks for replying! For a long time I am trying to tell the people that what matters, is blood flowrate, not BP. I am not surprised that you feel better with your HR (blood flow-rate) increased. As for yoga, in my opinion it is the best exercise for elderly people. It engages the whole body, and is not so strenuous as cycling or running. Regards!
I'm on BP lowering meds and also on Digoxin but my BB was halved along with my diuretic. I was hospitalised with flu in January for 3 weeks - nearly finished me off but although its taken me to May to recover properly I am feeling better than for the last 3 years! I use an oxymeter on occasions and my resting pulse rate is usually in the low 60's I'm comfortable with that and BP is fine. Ive had to give up 'proper' yoga as head down positions are not good and I have to pace arm movements above my head but seated yoga is just as effective.
Before I had an ablation my meds were keeping my HR down to about 55bpm. I felt like a zombi and everything (including thinking) was like wading through treacle. I feel much better with a higher heart rate - average now about 72.
I suppose that some. even many, of those who are taking a rate lowering drug would clearly have a background level of morbidity that is completely different from otherwise healthy people with a low heart rate (i.e. they would have an illness). This illness would likely affect their lifespan at times and give rise to the statistics you have found.
A fir person with a low rate will likely be an athlete of one who exercises regularly, and would, as a result, likely have a longer lifespan.
Maybe not athletes Steve. They push their bodies to the limits of human endurance. There was a programme on television recently about this with some dire consequences. I'm a great believer in moderation in all things.
I have a teacher friend who pushes herself to the limit. She collapsed during a marathon recently and ended up in hospital but still presses on. It's amazing how the fitness bug can become an obsession.
It's something in human nature... People rarely want to admit that they are getting older, getting less capable of doing things... I have a close friend, aged also 71, who is not married and discusses no other subject but women, like a teenager.
In the case of the teacher friend, yes, she's heading towards what we used to call middle age, and I suspect that to be a part of it. You did make me smile with your comment about your friend. Well, I suppose we will never know whether he is just more open or more obsessed! But he sounds a good kind of friend to me.
Yes, she collapsed with chest pains, was rushed in and kept overnight. She did stop for a while but is back. I warned her about AF but to no avail. She had a near fatal PE once and that, I think, is what spurred this love of exercise.
thanks for this Nesko. I have read the afib cure by Dr Day so glad to be pointed to this site and from there to a podcast about athletes and Afib. So much appreciated.
Thanks so much! Almost got kicked out of the forum because of this, lol... And..., not my story at all - I have taken all of it from Dr. Day's podcast!
that’s ridiculous in the 150s because I spent over a year like that and it caused heart failure. It wasn’t my doctors fault I was in between doctors because of the previous. So glad you did the right thing.
Yes. No followup after stroke and no heart specialist following up on a high H/R. Just left me so from September 2019Stroke with AF-December 2021 I was struggling.
I had to pester my Dr and DHB Heart Specialist that I had no quality of life.
The Private H/Specialist found me @ 120 plus H/R at rest in his clinic.
Honestly I felt I was nearly at the end of my journey.
Perhaps because throughout my avge H/R at night was low at 47 H/R.
That's when I had the stroke at night at 2am.
Good that your Pacemaker is making your life easier. You are learning well.
oh my goodness that sounds similar to what I went through a year ago. I had constant heart rate 150+ for almost a year and could not even get a callback from doctor or staff. Now that I am starting to feel well I am considering legal action. I documented everything and have copies of all the times. He never answered me when I requested. He didn’t even tell me to go away. I heard nothing from him or the staff time and time again. I Ended up with heart failure specifically I have been told because of how long I had that high heart rate/tachycardia. My circulation was barely there. I could not walk, and even for the pacemaker I went in by wheelchair. The good thing is, I walked out the following day, which, in itself is a miracle, never mind everything else.
The EP/doctor I had used his own pioneered procedure, which had been written up everywhere. I’m beginning to think that because it did not work. Plus he was wrong about so much. I have now found out, I think he didn’t want anyone to know about me, and stopped acknowledging me when I was not successful having his procedure. I really feel as though I was used. When I spoke to my previous CPA in Florida, he told me I needed a new doctor ASAP. That’s very unusual for a doctor to say anything like that. But I was doing good under his care. I think he was disgusted with the other doctor. The thing is they recommended him to me when I was moving because of his students was now working for my doctor in Florida. In the hospital and everywhere people think he’s a god on a pedestal. I liked him until he did this to me. He even told me I no longer have flutter, which was a lie. I not only still had it, but I have a typical flutter. He also had me on the wrong medication after the surgery. He took me off the wrong one and the one he left me on did absolutely nothing for me to keep me in rhythm. Again this time it was my new cardiologist. Houston is known for the medical community it has, in the particular hospital I had been in is wonderful. I believe it’s number one in the world not just country. The EP is the only bad thing I can say about going there. Whatever happened to the oath wear a doctor says he will do no harm? I guess being a celebrity is more important.
thank you for being supportive through everything since I joined here. Never did. I think I would feel this good again.🤗
I do agree. Where I live you can't go anywhere without going up/down hills. Great cardio work out here!!Can't beat a really good cardiologist.... So glad you took steps to see one.
Yes thank you for this. My EP expressed similar reasoning as this podcast, when I saw him a month after my first Feb 6th AFib. After viewing my stress tests, labs, seeing my natural HR of 48-50, and hearing my lifestyle of consistent exercise, healthy eating, usual healthy weight, borderline high BP in hospital but not at home, and tendency towards high vagal response (pre-syncope and syncope episodes, verified by positive tilt table test result), he recommended this for me: Apixoban. No beta blockers because of bradycardia and Vagal AF. Ablation (was May 31st) asap since AF became daily quickly and very symptomatic. Amiodarone temporarily (HR low 40’s, a necessary evil for awhile) until 8 weeks post-ablation. If I have even one AF, they said they’ll double the amiodarone temporarily. He’s encouraged gradually increasing my exercise (to reduce need for meds and lowers risk of recurring AF!), to even endurance-type but keep an eye on HR ie keep intensity to 145’ish. Makes total sense to me, for active people with natural sinus bradycardia. Again thanks for the link. I appreciate all insights on here, and even ones that seem crazy, often have something to be gleaned from 😊
Thanks for the reply and support! I thought that it would be good to point out to this podcast since it shows that too much of BB may be bad for people's health. Kind regards!
I have a state of the art pacemaker I’ve had at three months now. The first month it was set for 80 because I had tachycardia for over a year with rates in the 150s constant so even 80 was is slow for me. The following month after my check up, it was brought down to 70 without any problems. Recently, it was lowered again this time to 60. While I was still in the car heading home I felt the familiar thump of afib. I stayed that way for almost 4 days and was about to ask to go back and have it raised but suddenly I felt so much better. People need to remember that this truly is resting and that once you start moving about your heart rate will rise. I didn’t quite get that in the beginning that I am like a normal person again who has a heart rate that rises when you are active. There is nothing normal about a fib.
One other thing people should know if they do not. If you have a pacemaker, you have to absorb a lot of information and sometimes you lose some of it. I did not realize that I would still have a fib, feelings and my atypical flutter. The difference is they can no longer affect my heart, but I can still feel them. If you don’t know that it can be a bit. Frightening when it happens. I just had an extensive echocardiogram and ECG. My doctor told me that doctors want to learn how to get your patience to have testing come out like mine He was beyond happy with what I have now. My blood pressure has also gone up a little bit which is good because I tend to run low almost too low.
I know my answer is not for everyone but I thought I would share what I have recently learned. Anyone considering or getting a pacemaker be happy about it. Your quality of living is about to improve to where you never expected it to be again. One final warning please be careful in the hot weather. I thought I was yesterday. It knocked me for a loop anyway causing exhaustion and even some breathlessness. I love the hot weather but I don’t think it was just me any longer KEEP COOL
Now leads and no leads etc technical is on the up. You are like us all the guinea pig!
I was told by someone with AF that her specialist wants her H/R at rest to be 65 or lower.
I can tell you when my controlled on meds H/Rate dropped from 88-96 to now 62-69 I have felt heaps better on exertion.
But blood test shows cholesterol at 7.2 up from 6.2! Was it the daily Almond Non Dairy Icecream!
Have a lovely summer. We are in the depths of winter but @ 16 degrees, blue sky, no wind it's great. I witnessed 5-6 seals, orca, whales having fun and feeding with the line of bait fish in our Doubtless Bay last Sunday. Magnificant!
well that’s good for me my resting heart during the day is about 42bpm. My bp is normal and apparently have good blood flow. Never been an athlete or particularly exercised. Still have afib though !
Bit of a scary statistic. But it's all about context and this is missing. We don't all start from the same starting point and frankly we are all different. It's science that tries to club us all together. Some healthy well people have a naturally low heart rate. If the body is balanced and still getting what it needs ( purpose of the heart in the first place) surely this puts less stress on the heart.
More info needed. And a body of research to substantiate this claim.
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I like John Day, but he's a writer and needs space to fill. Would not put a lot of importance into this particular article.
But he sounds a good kind of friend to me.
Heart rate?
what is a good resting heart rate 
Heart rate post exercise. 
Resting heart rate
should I be concerned? 
