A lower resting heart rate goes with lower health risk

A lower resting heart rate goes with better long-term health. Each 10 extra beats per minute at rest goes with about 9% higher risk of early death, and the risk climbs steadily rather than starting at one number. Above 80 bpm the risk is clearly higher, and from 90 bpm heart disease risk rises too. This comes from one large review of 46 studies, and it shows a strong link rather than proof that a lower heart rate causes better health.

Why it works

A lower resting heart rate usually means your heart moves more blood with each beat, which endurance training builds. A high resting rate can also reflect strain on the heart or other health problems, so it works as a marker as much as a cause.

The evidence

• Zhang, D., Shen, X., Qi, X. (2016). Resting Heart Rate and All-Cause and Cardiovascular Mortality in the General Population: A Meta-analysis. CMAJ.

  Each 10 bpm higher resting heart rate went with 9% higher all-cause mortality and 8% higher cardiovascular mortality. Compared with the lowest group, 60 to 80 bpm carried 1.12 times the all-cause risk and above 80 bpm carried 1.45 times. All-cause risk rose in a straight line from 45 bpm, and cardiovascular risk became significantly higher at 90 bpm.

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Why we call confidence medium

One meta-analysis of 46 cohort studies (about 1.25 million people) anchors this (Zhang 2016). The link held after adjusting for standard heart risk factors. The authors also found wide differences between studies and signs of publication bias, and the data are observational. Lowering resting heart rate on its own is not proven to cut risk.

Where it applies

General adult population in prospective cohort studies.