Is a low resting heart rate bad?
It can be fine, if you feel well. Under 60 can be OK if you’re fit, asleep or on beta blockers. But the same 48 can mean two different things. One question tells them apart.
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Is a resting heart rate of 50 OK if I’m not an athlete?
Often, if you feel well. A normal resting rate for adults is usually 60 to 100 beats a minute. Some people sit outside it, the British Heart Foundation (BHF) says.
Under 60 at rest is called bradycardia. For some people it’s fine, the BHF says, such as if you’re very fit, asleep or taking beta blockers.
- Below 60 bpmSlow. Can be fine if you feel well.
- 60 up to 100 bpmUsual resting range for adults.
- Above 100 bpmFast at rest. BHF: see a GP.
Sources: BHF; BHF: checking your pulse
You don’t need to be an athlete. A US study followed adults aged 45 to 84 with no heart disease. Among those not on heart rate medicines, about 1 in 20 were under 50.
Over 10 years, their risk of heart disease or death was no different from people at 60 to 69.
So what tells a harmless 48 from one that needs a check? One question: do you feel faint, dizzy or very tired?
If not, the study above found a pulse under 50 was not linked to extra risk in adults not on heart medicines. If you do, the BHF says see your GP.
What does a low pulse rate mean?
It can mean a fit heart, sleep or a medicine. It can also come from an underactive thyroid, or the heart’s wiring being slow to pass on each beat.
| Reason | What the sources say | Clue |
|---|---|---|
| Fitness | Can be normal if you’re very fit and active. | You feel well and exercise a lot. |
| Sleep | Can be OK to be under 60 while asleep. | Low overnight on a watch, normal by day. |
| Beta blockers | These medicines slow your heartbeat. | You take one, such as bisoprolol. |
| Underactive thyroid | Can cause a slow heartbeat. | Tired, cold and gaining weight. |
| Heart block | Signals that set each beat are blocked or delayed. | Dizziness, fainting or breathlessness. |
Sources: BHF; NHS: beta blockers; British Thyroid Foundation; NHS: underactive thyroid; NHS: heart block
Heart block is most often caused by a heart condition, such as coronary heart disease or a heart attack. Some medicines can cause it too.
You may have no symptoms. If it isn’t causing any, you won’t usually need treatment. The main test is an ECG, a few minutes of stickers on your chest that record your heartbeat.
Tired, cold and slow? Read underactive thyroid symptoms and ask your GP about a thyroid blood test.
Is a resting heart rate of 45 too low?
Not on its own. No UK source gives a single number that is too low for everyone. The same symptom question applies at 45 as at 55.
A slow pulse is a bit like a car ticking over quietly. Quiet is fine if it pulls away well. If it splutters when you set off (faint, dizzy, very tired), get it looked at.
On a medicine that slows your heart? In the same US study, a rate under 50 in people taking one was linked to a higher risk of death. That’s a link, not proof the slow rate caused it.
The BHF says to speak to your doctor if you notice a change in your heart rate when taking medicine. Never stop or change a prescribed medicine without your prescriber.
A woman with a pulse of 52? Women’s resting rate is slightly higher than men’s on average. The same rule applies: how do you feel?
Whatever your number, the check is the same: if you feel faint, dizzy or very tired, book a GP appointment.
Why is my blood pressure high but my heart rate low?
Check your tablets first. Beta blockers are often used for high blood pressure, and they work by slowing down your heartbeat.
Their common side effects include dizziness and tiredness. If you feel dizzy after taking one, the NHS says don’t drive, ride a bike or use machinery until it stops. Never stop or change a prescribed medicine without your prescriber.
Not on tablets? An underactive thyroid can cause both a slow heartbeat and slightly raised blood pressure. A GP checks it with a blood test for TSH and T4, two hormones that show how well your thyroid is working.
Not sure your blood pressure reading is high? See blood pressure readings explained.
How do I check my resting heart rate?
Check your resting pulse in four steps
- 1
Sit still
Sit or lie down for 5 minutes. No caffeine or cigarettes first.
- 2
Find it
Two fingers on the inside of your wrist, at the base of your thumb.
- 3
Count
Count for 30 seconds and double it. Irregular? Count a full 60.
- 4
Repeat
Check at the same time every day.
Source: BHF: checking your pulse
Using a watch or ring? The BHF says heart rate monitors can help you track your health, but they cannot diagnose a condition. See how accurate smartwatches are.
What to do about a slow pulse this week
- Check your pulse after sitting or lying down for 5 minutes, before caffeine or a cigarette.
- Count for 30 seconds and double it, at the same time each day.
- Note whether you feel faint, dizzy or very tired.
- On a beta blocker and feel dizzy? Don’t drive, ride a bike or use machinery until it stops.
- Noticed a change in your heart rate on a medicine? Speak to your doctor.
- Slow pulse and feel faint, dizzy or very tired? Book a GP appointment.
Sources: BHF; NHS: beta blockers
When to speak to a GP
A slow pulse matters most when it comes with symptoms. Book an appointment if:
- Your pulse is slow and you feel faint, or you have fainted. The BHF says see your GP.
- Your pulse is slow and you feel very tired, low on energy or dizzy.
- Your heart rate is consistently slow, fast or irregular, especially if you feel faint or dizzy too.
- You notice a change in your heart rate after starting a medicine.
Get help from NHS 111 if you feel dizzy all the time or it keeps coming back, or you’ve fainted. Also call if you get short of breath that gets worse when you’re doing your normal activities, or when you lie down.
Call 999 if you’ve been diagnosed with heart block and have chest pain. Also call if you have severe difficulty breathing, or feel sweaty, sick or lightheaded.
Call too if someone faints and isn’t breathing or can’t be woken within 1 minute. Don’t drive yourself to A&E.
Is your heart racing, pounding or fluttering right now? Call 999 or go to A&E if you also have chest pain or shortness of breath, or feel dizzy or lightheaded. The same goes if you faint or feel like you might faint.
See also dizziness and blood tests and heart palpitations.