Heart rate very low, how normal is that? - British Heart Fou...

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Heart rate very low, how normal is that?


Hi all,

I had angioplasty and 3 stents inserted about 6 weeks ago. I never had a heart attack, just quite blocked coronary arteries. Stenting most likely saved my life and I generally feel great. I exercise daily and run 5km (under 30 minutes) about 4 times a week. My question is about my heart rate which is usually between 38 - 52 bpm. That seems too low and worries me a bit even though I generally never felt better. I have a heart sensor on my watch and it measures HR every hour so I can see that is constantly lower than normal (61-75bpm).

I'm taking Clopidogrel 75mg, Aspirin 75, Bisoprolol 2,5mg and Atorvastatin 40mg, 1 of each every day.

I *think* it's Bisoprolol that does it but should I lower the dosage or something?

Thanks for reading.

27 Replies

I’m not medically trained, but you are correct in assuming that bisoprolol will lower your heart rate. What is your blood pressure, do you measure that too? 38 bpm is low but both your drugs and your seemingly good general fitness will contribute to this. Whatever you do, do not unilaterally adjust your dosage. Go and see your GP and have the discussion with them before you do anything with your medication.

HB-HB in reply to stevejb1810

I most definitely wouldn't lower my dosage without asking my GP, I was just wondering if it's normal. It is not a problem (I feel fine - not tired or lethargic) and I don't think I should waste my GP's time over it. Thanks for your reply, much appreciated.

stevejb1810 in reply to HB-HB

Understood. Just by way of comparison, Chris Froome’s resting heart rate is quoted as 32bpm and he is super fit. My bisoprolol induced resting heart rate is around 58bpm and, triple CABG aside, I’m pretty much your average joe

HB-HB in reply to stevejb1810

Mine changes often, from 38 (lowest recorded) to rarely over 60, mostly below normal range and usually in the 40s. It was slightly concerning but also motivating as it pushed me out for a run to raise it at least for a while.



I have a historically low heart rate, usually in the 50’s, probably because I have exercised all my life.

Since developing microvascular heart disease and taking Nebivolol ( a beta blocker ) mine sits quite comfortably in the 40’s and I don’t have any symptoms due to it.

The important thing about “ normal “ heart rate or blood pressure etc is what’s normal for you as the range is quite large. If you feel fine with a low heart rate then I wouldn’t worry too much. Symptoms to look out for would be feeling dizzy or passing out.

HB-HB in reply to Hidden

Thanks for your reply. I do feel dizzy sometimes, especially when I get up too quickly but that is not too often and is not alarming. I think taking all this medication is doing it's thing and some side effects are unavoidable.

Hidden in reply to HB-HB

I get that occasionally as well.

Recently started on Isosorbide mononitrate which is making my usually low BP even lower still but increasing it very slowly.

It’s an interesting thought about medication, it’s all risk V benefit. I don’t think any of us like taking meds but for me they have made a difference to my quality of life.

My resting heart beat had been in mid 50s, not due to any condition but being a runner. I was really concerned when my cardiologists decided to prescribed the BBs (2.5mg bisoprolol). The effect of BBs was immediate as my RHB went down to low 40s and often as low as 38. I am sure during the sleep its probably lower than 38. As for the side effects, well it has been very strange, I have some bad days and some not so bad days but I can still go out for my runs and have no effects during or after the run, feel so blessed that I can still do that.

If you are having no ill effects then I would not worry about it at all.

HB-HB in reply to mandm65

Before I had angioplasty, I was never a runner. I smoked, drank and I ate whatever and whenever I wanted for decades. Over the years it cought up with me. In June last year I stopped smoking because I couldn't cope with it any more, this is the period when I realised something's not right, discovered high BP and my HR was often over 100bpm. Went on a diet but it was too late, my arteries were blocked and I had angioplasty and 3 stents about 3 months ago. I now go for a 5k run most days, recently managed to run it under 30 minutes.

I have HB monitor on my watch and last night it was mainly in 50s which feels a little easier to accept than the 40s.

mandm65 in reply to HB-HB

I think its very impressive that you can run 5K under 30 minutes, considering you only took up running not long ago. I guess we are a classic example of two people coming from two different spectrum of the scale and yet with similar RHRs. I always advocate that having the same conditions/medication does not necessarily means that our body would react in a similar manner and you have just proved that.

Its also interesting that having lower RHR does not affect me as much as it does to most people here, it appears that I can manage my days without having to deal with lower HR challenges.

I also run with a HR monitor, Garmin, and to be honest I don’t pay much attention to it while running, use that as a recording device. I firmly believe that we must listen to our body and adopt accordingly.

I had a slightly different challenge than yourself and how I address that challenge was also different, if you have time have read below link, it might help you to deal with your challenge better.

Whatever you do, keep running.


HB-HB in reply to mandm65

Well done for completing your marathon after the HA, it's no mean feat.

My next challenge is to get faster and run 5K under 25 minutes before moving on to 10K under 60 minutes or better. I need to get my weight down some more (I'm down to 85kg from 96, optimum would be between 73-77kg at 180cm height) and would like to move on to compete in Tough Mudder Challenges or similar. In a way, my condition was a blessing as I'm really enjoying this new lifestyle, I haven't felt this alive in a long time.

Thank you for your posts, they're a good reading to anyone feeling a bit down after heart event. Best wishes.

mandm65 in reply to HB-HB

Thanks, glad to know that you found it a good read. Like I said we all have different way of keeping ourselves motivated and there is not a right or wrong way, its just what you as an individual want to achieve.

You can certainly concur your challenge and get your 5K time under 25 minutes, you have will and you have desire, two important ingredients. I guess your other challenge to bring your weight down to 73-77kg will help you enormously to get your 5K time below 25 minutes. You can start working on increasing your training run distance now for your 10K preparation, increasing running distance will also help you to get your 5K time below 25 minutes.

Do come back and let us know when you achieve those objectives.


I often "assumed" that people who have a low blood pressure automatically have the lower end of HR. Something worth looking into (for me). I am known to have bradycardia.

Thank you for sharing.

mandm65 in reply to Hidden

In my experience there is not a direct correlation between low blood pressure and lower end of HR, it would be interesting to read your find.

Lower RHR (Resting Heart Rate), tends to indicate the fitness levels, most athletes tend to have lower resting heart rate and some of the supremely fit athletes have RHR in early 30s.

Hidden in reply to mandm65

"Lower RHR (Resting Heart Rate), tends to indicate the fitness levels, most athletes tend to have lower resting heart rate and some of the supremely fit athletes have RHR in early 30s."

Yes, thank you for your helpful input. I was rather surprised by all the Cardiologists being so aloof over my longstanding bradycardia and symptoms over the years. "supremely fit athletes" can be having the lower HR whilst others aren't athletes with bradycardia. In my experience, Cardiologists take one quick glance at your feet to look for any signs of swelling. Once he is satisfied that there's no swelling, he thinks "all is well (read: "stop wasting my time - I'm a busy doctor".

WRONG! Thanks to this valuable site, I'm learning something new daily.

mandm65 in reply to Hidden

No worries, happy to help.

You are right when I referred to lower RHR, I was referring to supremely fit athletes not people with symptoms/medications/bradycardia. I guess we have different experiences when visiting Cardiologists, so I would not like to say that all our experiences are similar. I feel very fortunate that my Cardio team has been fantastic, and I have nothing but praise for them.

My heart rate at resting is in the low 40s. Fir this reason I was never given beta blockers. I don't have too many problems except I cannot get up from seating too fast. The blood doesn't always get to my head before I have gotten up so I get dizzy. Twice in the last 5 years I have fainted. So I have modified how I get up. Slowly and pause when up. Not immediately walk off. Of course sometimes I forget to do this. Its not everytime. All my pills have been modified so I don't take anything that will affect this. It is as it is.

Hidden in reply to Andyman

Do you ever get an impression that your cognitive function might be affected e.g. cog fog, as a result of your LHR, Andyman?

Andyman in reply to Hidden

I am not sure what you are asking. Can you explain please? What is cog fog for instance?

Stumpy47 in reply to Hidden

Definitely, family have noticed it too, more funny than disturbing at the moment, I'll stop mid sentence looking for words or phrases!! A bit like going to a room to do something & then forgetting what you were going to do !!

Definitely go and discuss with your GP. I was on Bisoprolol for over 10 years but after drastically changing my diet when I found I needed a bypass I lost 10 kg and was able to ‘control’ my BP and biomarkers without the need for pills. Came off the beta blocker first, my pulse was down to about 45 and I occasionally felt a little dizzy when I got up from sitting down for a while. Came off statins too a year later, now just on aspirin. I stated Parkrun in August and manage about 35 mins for 5k, so in my opinion you sound in perfect shape and if you are controlling your nutrition too you may not need all these pills. Do let us know how you get on.

bobaxford in reply to bobaxford

PS my resting HR is about 55, as I said was down to about 45 will on meds.

Thanks, I'll give it few more weeks, I feel it's still early days to get off medication. It would worry me too much even though my diet is much healthier than before , I eat mainly vegetables, fruit, whole grains and nuts. I'm down to 85kg from 96 since September, still few over (180cm tall, 46YO) but the weight coming off slowly. When I reach my optimum (75-78kg) I'll check it with my GP if it would be safe to reduce or stop some of the meds I'm taking. That would be great though. In the mean time, I'll try to run my 5k under 25 minutes. That is my next challenge before moving on to 10k.

Hi i had low blood pressure and it's been a constant worry for me, 85/58 . I had to come of ramipril as I had a reaction to it .I was put on canesartan instead 16 mg. over the last few wks my bp was very low.. I was told to only take 4 mg as off yesterday and my bp is gradually going back up... I was also told low blood pressure is only a problem if its problematic. Like dizziness etc. Take care .x

Hi my current situation on 10mg Bisoprolol

Well little did I know 3 weeks after my post I would have spent 36 hours in cardiology with you guessed it Ectopic Beats. It varied from 1 in 2 1 in 3 and the clincher for admittance was every other heart beat an ectopic for an hours duration. They really started to make me feel unwell and triggered a bout of fast heart beats. I had recently increased Bisoprolol from 7.5 to 10 mg and Candesartan from 16 to 32mg. In the Medical Assessment Unit the Consultant said to go back to 5 mg Bisoprolol, and when I moved on to Cardiology the junior Dr went tut tut stay at 10 mg, During my stay my BP was around 115/60ish with a pulse of avg 33 BP. So back to see the Heart Failure Nurse on Monday who should have access to the 24 hour ECG recording !! One thing I did learn ( well nearly ) is that during a bout of Ectopic beats the pulse is almost irrelevant, because it throws the BP monitor off the correct reading !! Hence Heart Rate was checked by the old fashioned fingers and watch method. So we will see next week who has sway, Heart Nurse and GP (close relationship ) or Junior Dr in Cardiology.

Prada47 in reply to Prada47

A post script to my post. The young Cardiology Dr said a huge run of Ectopic Beats can be triggered by anxiety, which releases adrenalin . I will ask on Monday if that's the case why does 10mg Bisoprolol not Block that Out ?? Anyone know ??



Hi Prada, I'm not sure if anyone is following this post any more, maybe start a new to get more responses? I really don't know anything about Ectopic Beats or Bisoprolol. I'm taking 2.5mg and I don't have any issues with it. Even my RHB have risen and is in mid 50s - low 60s.

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