Biomarkers · Cardiac & Hemodynamics
Resting Heart Rate (RHR)
Lower values go with lower risk of death. In NHANES 1999–2018 with linked mortality to 2019, each standard deviation above average goes with 21% higher risk of death. We found the same pattern in NHANES
RHR and risk of death
Published curve higher than the NHANES fitNHANES fit higher
Risk of death relative to each curve's own reference value, so the two curves need not cross 1 at the same point. The dotted vertical line marks the NHANES median.
RHR across cohorts
RHR by age and sex
Each bar runs from the 5th to the 95th percentile, the darker part from the 25th to the 75th, and the tick is the median. Not a reference range or a target.
The percentiles as a table
| Sex | Age | 5th | 25th | Median | 75th | 95th | n | Cycle / source |
|---|---|---|---|---|---|---|---|---|
| All | 20-39 | 56.0 | 66.0 | 72.0 | 80.0 | 92.0 | 1,455 | NHANES 2017-2018 |
| All | 40-59 | 56.0 | 64.0 | 72.0 | 78.0 | 92.0 | 1,576 | NHANES 2017-2018 |
| All | 60+ | 54.0 | 62.0 | 68.0 | 76.0 | 90.0 | 1,935 | NHANES 2017-2018 |
| All | all | 56.0 | 64.0 | 72.0 | 78.0 | 92.0 | 4,966 | NHANES 2017-2018 |
| Men | 20-39 | 54.0 | 62.0 | 70.0 | 78.0 | 92.0 | 706 | NHANES 2017-2018 |
| Men | 40-59 | 56.0 | 62.0 | 72.0 | 78.0 | 94.0 | 744 | NHANES 2017-2018 |
| Men | 60+ | 52.0 | 60.0 | 66.0 | 74.0 | 90.0 | 985 | NHANES 2017-2018 |
| Men | all | 54.0 | 62.0 | 70.0 | 78.0 | 92.0 | 2,435 | NHANES 2017-2018 |
| Women | 20-39 | 58.0 | 68.0 | 74.0 | 82.0 | 94.0 | 749 | NHANES 2017-2018 |
| Women | 40-59 | 58.0 | 64.0 | 70.0 | 80.0 | 92.0 | 832 | NHANES 2017-2018 |
| Women | 60+ | 56.0 | 64.0 | 70.0 | 76.0 | 88.0 | 950 | NHANES 2017-2018 |
| Women | all | 56.7 | 66.0 | 72.0 | 80.0 | 92.0 | 2,531 | NHANES 2017-2018 |
What studies found when this marker was changed
They describe what happened in those study groups, not a recommendation. See all catalogued interventions.
Measured changes in RHR, study by study
4 effects with a numeric size, each from one study arm: the dot is the reported change, the line its 95% interval where one was given. Green points move the marker the way lower risk of death lies; amber the other way. Study results in the groups studied, not predictions for a person.
| Type | Intervention | Reported effect | Evidence | Source |
|---|---|---|---|---|
| exercise | Endurance training / Aerobic conditioning | Endurance training significantly decreased resting heart rate in both sexes (effect size not reported) | meta-analysis | Reimers AK, et al. Effects of Exercise on the Resting Heart Rate: A Systematic… |
| exercise | Twelve weeks of combined aerobic and resistance training (60-min sessions including warm-up/cool-down) in sedentary hypertensive men | Resting heart rate fell 8.17 bpm after 12 weeks of combined training (also SBP -17.75, DBP -12.5 mmHg, weight -7.92 kg) | RCT | Alemayehu A, Teferi G. Effectiveness of Aerobic, Resistance, and Combined… |
| pharmacologic | Beta-blockers in heart failure with systolic dysfunction | Beta-blockers reduce resting heart rate; every 5 beats/min reduction associated with 18% lower risk of death (mean heart rate change not reported) | meta-analysis | McAlister FA, et al. Meta-analysis: beta-blocker dose, heart rate reduction… |
| pharmacologic | Sinoatrial funny channel inhibitor (Ivabradine 5-7.5 mg) | Reduced heart rate by 12.21 bpm (95% CI -15.47 to -8.96) vs placebo in HFrEF (nine RCTs) | meta-analysis | Waranugraha Y, et al. A Systematic Review and Meta-Analysis of Randomised… |
Things that worsen it
| Type | Condition or exposure | Reported effect | Evidence | Source |
|---|---|---|---|---|
| diet | High nicotine intake (acute nicotine exposure) | IV nicotine raised HR ~10 bpm (95% CI 7.8-12.3) at one minute and 13 bpm (95% CI 11.0-15.2) at two minutes in 213 smokers | non-randomised trial | Jensen KP, et al. Biochemical, demographic, and self-reported tobacco-related… |
| lifestyle | Prolonged bed rest (physical deconditioning) | 60 day head-down-tilt bed rest raised resting HR by 8.3 ± 6.3 b.p.m. (24 healthy persons) | non-randomised trial | Hoffmann F, et al. Cardiac adaptations to 60 day head-down-tilt bed rest… |
What else moves this marker
They describe those study groups, not an individual, and an association is not a cause.
Environmental and occupational exposures
| What | Effect on the marker | Comparison · population | Source |
|---|---|---|---|
| ↓ Daily cannabis use · daily use vs no current use | -2.1 bpm (95% CI -3 to -1.3) | daily cannabis use vs no current use · CARDIA cohort: 5115 Black and white US adults followed 30 years (35,654 examinations) | prospective cohort · PMID 35245494 |
Day-to-day noise on a wearable
How much a single day's resting heart rate from a consumer wearable moves around a person's own level, from months of free-living data in open datasets (same measure (device estimate)). ICC is the share of variation that is between people: near 1, one day tells people apart; near 0, it is mostly noise. The smallest detectable change (95%) is the change a single day, or a 7-day mean, must exceed before it is more than noise. Days to average assumes days are independent; for resting heart rate they are not, so the true number is larger.
| Dataset | People · person-days | Within-person SD | ICC: one day · 7-day mean | Detectable change: one day · 7-day mean | Days to average |
|---|---|---|---|---|---|
| LifeSnaps | 66 · 4,389 | 2.68 bpm | 0.87 · 0.98 | 7.42 · 2.81 | 14 for 2.00 bpm |
| PMData | 14 · 1,658 | 2.31 bpm | 0.89 · 0.98 | 6.41 · 2.42 | 11 for 2.00 bpm |
Sources
- Risk curve: Zhang D 2016 (PMID 26598376): all-cause RR 1.09 (1.07-1.12) per 10 beats/min increment of resting heart rate. Scaled to US values (NHANES).
- Zhang D, et al. Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis. CMAJ. 2016;188(3):E53-E63.
- Aune et al. Resting heart rate and the risk of cardiovascular disease, total cancer, and all-cause mortality - A systematic review and dose-response meta-analysis of prospective studies. Nutrition, metabolism, and cardiovascular diseases : NMCD. 2017;27:504-517.
- NHANES curve: our Cox model adjusted for age and sex, NHANES 1999–2018 with linked mortality to 2019.
Map Resting Heart Rate (RHR) against another biomarker.
Related markers: Abdominal Aortic Calcification (AAC) · Ankle-Brachial Index (ABI) · Cardiac (Valvular/Annular) Calcification · Carotid Intima-Media Thickness (CIMT) · Carotid-Femoral Pulse Wave Velocity (PWV) · Copeptin · Coronary Artery Calcium Score (Agatston) · Corrected QT Interval (QTc)