Low heart rate, should I be worried? - British Heart Fou...

British Heart Foundation

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Low heart rate, should I be worried?


I am taking Bisoprolol 2.5mg since my cardiac event in April. My heart rate when I was discharged from hospital was 60. Over time it has dropped to as low as 51. My question is should I be worried and call my HF nurse? I feel ok and can still do my normal routine. Thanks for any advice.

11 Replies

Hiya, as we sit here, mine is at 49. Before my HA back in June, I reckon it was @ 80/90 bpm (But can't be sure as never checked it!). I am on 1,25mg of Bisoprolol.

Dunno if this helps but hope it does.

Thank you CarlGreen for your reply. Yes it does help knowing that I am not alone in having a lower pulse. x

That's a pretty normal figure for many on bisoprolol, or even without. Especially if you've been improving fitness at the same time. I'm assuming it's been a fairly gradual change over a few weeks / months? If so, that'll be the drugs and any lifestyle changes doing what they're paid to do :)

A LOT of medical thinking suggests that the "normal" range should be redefined as 50 to 80 rather than the current 60 to 100 but old ideas take a long time to die.

Out of interest, in terms of what fitness can do, I've been off biso for nearly a year now and my resting pulse first thing this morning was 41 (typically between about 41 and 46). No symptoms, and it speeds up as expected when needed, so no worries :P

Thanks for your reply Thatwasunexpected. My normal routine is just using my exercise bike, short walks and general housework. I am not overly tired, no breathlessness , no fluid retention. I would say that as I have just celebrated my 75th birthday, I feel fortunate. Thanks for your reassurance. x

That sounds like the perfect routine for getting a nice low pulse, which saves your heart from working overtime!

Without some really intense exercise thrown in, it would probably be worth mentioning to the nurse if it starts dropping into the 40s but for now sounds pretty good for someone active and on biso :)


Could you share how you got off Bisoprolol?

Still not convinced quality of life and expectancy is best served by endless drugs.

I've kind of accepted that I'm on it for life, although on 1.25 mg with a resting HR of 50 bpm. BP is averaging out at 135/70.

I'm either cycling or playing tennis most days following stenting 5 years ago and AVR two years ago but fortunately not preempted by a heart attack.

So no real drama but some residual coronary artery disease and a bioprosthetic aortic valve which should be good for the next decade at least!

I asked my cardiologist and he agreed.

I was going to the gym twice a week and, a couple of times I genuinely forgot to take it, found I could work a lot better. GP wouldn't agree to stop it but accepted that "forgetting" it on gym days probably wouldn't matter.

When my 6 month cardio review came (after 9 months) I examined it to the consultant & he was happy for me to stop. Resting HR was around 54 at the time and average BP 105/65. Since then the exercise (lots of exercise!) has got HR down to mid / low 40s and BP averaging about 102/62.

In your case they may be a little cautious with your systolic pressure and the AVR, but biso won't be a huge factor in pressure anyway - it mainly affects heart rate and lower BP is just a side effect of the lower rates. Specific BP meds are much more effective at controlling pressure.

If you're decently active, symptom free, and stable it's certainly a conversation worth having with your doc. I hadn't really noticed it affecting me day to day but found the difference during strenuous exercise was like night & day.

And, where possible, activity just has to be better than pills!

Thanks for the prompt and comprehensive response.

Really just looking for enhanced performance during exercise which I feel is curtailed by beta blockers, albeit in principle, there for my own protection.

GP has not been receptive to any medication reduction and theres a revolving door for cardiologists at my local hospital - never the same face twice!

You have an envious BP and I guess I should count my blessings that at 67, I'm as active as I want to be (almost) and with a refreshed life expectancy, thanks to my AVR.

Just a nagging suspicion that without the pharmaceuticals, I would just be feeling that little bit sharper.


My resting heart rate is 45 and I am on 1.25 Mg Bisoprolol. This gives me no problems and it goes up if I start exercising.

I was taken off bisoprolol as my HR dropped to 42-43. It's now 55-56 at rest

If it's worrying you then of course you should call then. That's what they are there for.

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