A normal resting heart rate for an adult is between 60 and 100 beats per minute. That is the range used by the British Heart Foundation and by most doctors in the UK. Within it, a lower number usually means the heart is pumping efficiently, and very fit people can sit comfortably below 60 without anything being wrong.

What matters just as much as the number is the pattern. A resting rate that is consistently above 100, one that is below 50 and comes with dizziness or tiredness, or a pulse that feels irregular, is worth getting checked. A single fast reading after a coffee or a stressful phone call is rarely a concern. A rate that stays high or low day after day, or that changes along with new symptoms, is when a proper heart assessment makes sense.

How to measure your resting heart rate properly

The best time to check is first thing in the morning, before you get out of bed and before any caffeine. If that is not practical, sit quietly for at least five minutes first.

1. Place two fingers on the inside of your wrist, just below the base of your thumb, or on the side of your neck beside your windpipe.
2. Count the beats for a full 60 seconds. Counting for 15 seconds and multiplying by four is quicker, but it can miss an irregular rhythm.
3. Note whether the beats feel even and steady, or whether there are pauses, extra beats or a chaotic pattern.
4. Repeat over three or four mornings to get a reliable picture.

Smartwatches and fitness trackers give a reasonable estimate of resting heart rate, and many people first notice something unusual on one. In our experience, a manual pulse check works better than relying on a wearable alone when you are worried about a reading, because the watch can struggle with irregular rhythms and will not tell you whether the beat feels uneven. We’ve found that patients who bring both their watch data and a few manual readings to their appointment give us a far clearer starting point.

What affects your resting heart rate

Your heart rate is not fixed. It changes throughout the day and is influenced by several everyday factors.

• Fitness. Regular aerobic exercise strengthens the heart so it pumps more blood with each beat, which lowers the resting rate.
• Age. Resting heart rate does not change dramatically with age, but the maximum rate your heart can reach during exercise falls as you get older.
• Sex. Women tend to have slightly higher resting rates than men, partly because their hearts are usually a little smaller and pump less blood with each beat.
• Caffeine, alcohol and nicotine. All three can raise your heart rate temporarily.
• Stress and anxiety. Adrenaline speeds the heart up, even when you are sitting still.
• Illness and dehydration. A fever, an infection or not drinking enough can push your rate up.
• Medicines. Beta blockers lower heart rate, while some decongestants, asthma inhalers and thyroid medicines can raise it.
• Body position. Your rate is usually a few beats higher standing than lying down.

When a fast resting heart rate is a concern

A resting heart rate above 100 beats per minute is called tachycardia. Sometimes there is an obvious reason, such as a fever, dehydration or anxiety, and the rate settles once that passes.

When there is no clear cause, or the fast rate keeps coming back, it can point to a heart rhythm problem. The most common are atrial fibrillation, where the rhythm is fast and irregular, and supraventricular tachycardia, where the heart suddenly races and then stops just as suddenly. An overactive thyroid, anaemia and some lung conditions can also raise your resting rate.

From working with patients across Kent and East Sussex since 2006, we’ve found that people often put up with a racing heart for months before seeking help, assuming it is stress. Episodes that start and stop abruptly, especially with breathlessness or light-headedness, are worth recording and discussing with a cardiologist rather than waiting for them to go away.

When a slow resting heart rate is a concern

A resting rate below 60 is called bradycardia. In fit, active people this is often completely normal. Endurance athletes can have resting rates in the 40s and feel perfectly well.

A slow rate becomes a concern when it causes symptoms. Dizziness, fainting, unusual tiredness, breathlessness or confusion can all mean the heart is not pumping enough blood to meet the body’s needs. Causes include age-related wear in the heart’s electrical system, heart block, an underactive thyroid and some medicines, particularly beta blockers and certain heart rhythm drugs.

In our experience, a slow pulse in someone who has always been sporty but has recently started feeling faint or exhausted is one of the patterns most worth investigating. A rate that was once normal for that person can become a problem as the heart’s conduction system ages.

An irregular pulse

An irregular pulse is not always serious. Most people have occasional early or extra beats, often felt as a skip or a thud, and these are usually harmless.

A pulse that is irregular all the time, with no steady pattern at all, is different. That is the typical feel of atrial fibrillation, which raises the risk of stroke if it is not treated. If your pulse feels chaotic when you check it, see your GP, even if you feel well.

When to seek urgent help

Call 999 if you have a fast, slow or irregular heartbeat along with chest pain, severe breathlessness, fainting or signs of a stroke such as weakness on one side of the face or body or difficulty speaking.

For symptoms that come and go, the NHS advises seeing your GP if palpitations keep returning, last more than a few minutes or happen alongside a known heart condition or a family history of heart problems.

How a cardiologist investigates your heart rate

A single ECG reading in clinic only captures a moment, so the aim is to see what your heart does over time and under different conditions. Depending on your symptoms, the tests we use include the following.

• An ECG, which records your heart’s rhythm and electrical activity over a few seconds.
• A 24 hour ECG or 7-day cardiac event recorder, worn at home to catch rhythm changes that come and go.
• An echocardiogram, an ultrasound scan that shows the structure of the heart and how well it pumps.
• An exercise stress test, which shows how your heart rate and rhythm respond to exertion.
• Blood tests, including thyroid function and checks for anaemia.

At our Warwick Park practice in Tunbridge Wells, most of these tests are carried out on site, so you can often have your consultation and investigations in the same visit. Our consultant cardiologists also hold NHS posts at Tunbridge Wells Hospital and King’s College Hospital, and we aim to send a letter to your GP within 24 hours of your appointment.

Conclusion

A normal resting heart rate for adults sits between 60 and 100 beats per minute, and fit people can safely sit below that range. The number alone rarely tells the whole story. A rate that is consistently fast, slow with symptoms, or irregular, is worth having checked, particularly if it comes with dizziness, breathlessness, chest discomfort or fainting.

If you are concerned about your heart rate, West Kent Cardiology Partnership can assess your symptoms and arrange the right tests, usually at our Tunbridge Wells practice. Contact us or call 01892 526726 to book an appointment.