Normal Heart Rate and The Danger of Abnormal Heart Rhythms

How many times should your heart beat in a minute? When at rest,  the normal heart rate ranges from 60 to 100 beats per minute (bpm). A rate below 60 bpm is considered bradycardia (slow heart rate), while above 100 bpm is tachycardia (fast heart rate). According to Dr Andrew Kong, a General Practitioner, heart disease can result in permanent disability, and both slow and fast heart rates may be early warning signs of cardiac conditions, which in severe cases can lead to sudden death. So, how can -you gauge whether your heart beats in a healthy way? Read on for a step-by-step guide. 

What Is the Normal Heart Rate?

Heart rate refers to the number of times your heart beats in one minute,  that goes hand-in-hand with heart rhythm, which is  the regularity of those beats. A healthy adult at rest should have a heart rate between 60 and 100 bpm, with a steady, regular rhythm. If your heart rate falls below 60 bpm or exceeds 100 bpm while at rest—or if your heartbeat is irregular, even with a normal heart rate, you may be experiencing arrhythmia.  

Heart rate is influenced by factors including age, physical activity, emotional state, cardiac function, and overall health. For example, young athletes often have a resting heart rate as low as 30 to 40 bpm, likely because regular exercise strengthens and improves efficiency of the heart muscle, enabling it to pump more blood with each beat. That is why athletes have fewer heartbeats per minute compared to non-athletes.   

Factors that influence resting heart rate

• Age
• Exercise  
• Fever (increases heart rate
• Dehydration (increases heart rate)
• Ambient temperature (heat can increase heart rate)
• Emotional or psychological state (stress, fear, anxiety and excitement increase heart rate)
• Medical conditions (hypothyroidism can present with a slowed heart and hyperthyroidism can result in the reverse)
• Medications (beta blockers may slow heart rate; thyroid medication may increase it)
• Smoking (increases heart rate)
• Caffeinated beverages (increases heart rate) 

What Is Arrhythmia? 

Arrhythmia refers to an abnormal heart rhythm, which may be too fast, too slow, or irregular, usually caused by issues within the heart's electrical conduction system. Common types include tachycardia (fast heart rate) and bradycardia (slow heart rate). Some people experience no symptoms, while others may notice palpitations, lightheadedness, fainting, chest pain, or shortness of breath. Other,  more concerning arrhythmias, include atrial fibrillation, ventricular tachycardia, and ventricular fibrillation,  that may be caused by heart disease,  electrolyte imbalance, thyroid disorders or side effects of medication. Diagnosis of arrhythmias typically relies on electrocardiography (ECG or EKG) or other monitoring devices (e.g. Holter device) and, after addressing the root cause, management   ranges from simple carotid massages, medication,  ablation, pacemakers or even defibrillators. 

Types of arrhythmias 

1. Tachyarrhythmias (fast beats) 

• Atrial Fibrillation
• Ventricular Tachycardia
• Ventricular Fibrillation
• Supraventricular Tachycardia

2. Bradyarrhythmias (slow beats) 

• Sinus node dysfunction
• Heart blocks 

How to Measure Your Heart Rate Without Equipment? 

There are several ways to check your heart rate, but the simplest method requires only three fingers: 

• Use the tips of your index, middle, and ring fingers to gently press on the radial artery, located on the thumb side of your wrist, until you feel your pulse. 
• Count the number of beats you feel in 15 seconds. Multiply this number by four to get your heart rate in beats per minute. 
• If you cannot detect your radial pulse, you can also use your index and middle fingers to find the carotid artery in the  triangular space in the neck bordered by  your windpipe in the middle, the lower end of the jaw above and the oblique neck muscle on the side (the sternocleidomastoid). Similarly, count the beats for 15 seconds and multiply by four. 

Heart Rate Differs in Children, Elderly and Pregnant Women 

Heart rate varies slightly between children, adults, the elderly, and pregnant women: 

Adults 

Approximately 60–90 bpm 

Infants 

Approximately 100–120 bpm 

Children 

Approximately 80–100 bpm 

Pregnant women 

Approximately 70–90 bpm, increasing by up to 25% in late pregnancy

Physiological heart rate, exercise and the elderly 

Elderly people may have slightly slower heart rates than adults but rates above 50 bpm are generally acceptable. The American Heart Association computes the maximum physiological heart rate at roughly 220 minus your chronological age, thus as we grow older, this gets lower. Accordingly, for moderate-intensity activities such as brisk walking and swimming, the target heart rate is placed at 50 to 70% of the maximum heart rate, which is projected to be in the following ranges: 

What Do Fast or Slow Heart Rates Indicate? 

As stated previously, our heart rate depends on factors such as age, ambient temperature and physical activity. However, a persistent abnormally fast or slow heart rate may signal problems with the heart's electrical system, which regulates rate and rhythm. If left unchecked, these irregularities can cause symptoms such as palpitations, lightheadedness or fainting, and can be debilitating and life-threatening. 

Tachycardia (Fast Heart Rate) 

A heart rate exceeding 100 bpm is termed tachycardia. This may be caused by fever, dehydration, anxiety, exercise, hyperthyroidism, anaemia, or certain medications. If you have no symptoms, treatment is usually unnecessary. However, if your heart rate remains consistently above 100 bpm, you are advised to see a doctor promptly to rule out serious conditions like heart disease and adverse tachyarrhythmias such as atrial fibrillation or ventricular tachycardia.

Bradycardia (Slow Heart Rate) 

A heart rate below 50–60 bpm is termed bradycardia and is common in people with hypothyroidism or those taking medication for high blood pressure or arrhythmias. The slowed heart may fail to pump enough blood over time and this can lead to chronic oxygen deficiency, compensatory ventricular remodeling (leading to heart failure), or even sudden death due to complete heart block or asystole. If your heart rate drops below 50 bpm or you experience pauses of more than three seconds or you have symptoms such as chest pain, lightheadedness, fainting or shortness of breath, seek medical attention immediately;  cardioversion or a pacemaker may be necessary to stabilise your heartbeat and prevent sudden death. 

Are Smart Watches Accurate for Measuring Heart Rate? 

In recent years, wearable devices have become popular for tracking heart rate and rhythm 24 hours a day, and some even show ECG results. However, doctors warn that smart watches can be inaccurate if not worn snugly, leading to unreliable data due to poor contact. These readings should only be used for reference. If you suspect abnormal heart rhythms or oxygen levels, consult your doctor as soon as possible. Traditional ECGs, which use multiple electrodes on the chest, provide much more accurate data for diagnosis and treatment decisions. 

Foods to Avoid for Arrhythmia Patients 

People with arrhythmias should pay attention to their diet, as certain foods may worsen their condition. Below are some general recommendations. As individual needs vary,  always discuss with your doctor or dietitian. Patients with arrhythmias may avoid:  

• Caffeinated foods and drinks: Coffee, tea, some soft drinks, and chocolate contain caffeine, which can trigger arrhythmias in some people. Sensitivity varies from person to person so some may need to avoid caffeine entirely, while others can tolerate moderate amounts.
• High-sodium foods: Excessive salt intake can raise blood pressure and strain the heart, potentially worsening arrhythmias. Limit processed foods, fast food, and salty snacks. 
• High-fat and high-cholesterol foods: These can aggravate cardiovascular disease and harm heart health. Limit fatty meats, full-fat dairy products, fried foods, and processed foods containing trans fats. 
• Excess sugar and refined carbohydrates: These can cause spikes and crashes in blood sugar, increasing cardiac stress. Avoid sugary drinks, sweets, and white bread.
• Alcohol: Excessive drinking can trigger or worsen arrhythmias, especially atrial fibrillation. It’s advisable to limit or avoid alcohol.
• Supplements high in calcium, magnesium, or potassium: Avoid excessive intake unless prescribed, as these minerals affect cardiac electrical conduction.

Remember, everyone reacts differently to certain foods. Adjust your diet based on your health condition and your doctor’s advice. If you suspect food or drink affects your heart rhythm, keep a diary and discuss it with your healthcare provider. 

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OT&P Healthcare Advice 

Dr Andrew Kong advises regular health check-ups to effectively reduce the risk of heart disease. Arrhythmias may indicate underlying serious health issues, so monitoring heart rhythm is especially important for those with chronic conditions. If you experience symptoms such as palpitations, dizziness, or shortness of breath, seek professional advice from our GP or cardiologist immediately. Do not delay—your heart health is vital. 

Dr Andrew Kong

Family Medicine, General Practice

• LMCHK
• MBBS (Newcastle University, UK)
• FRACGP
• FHKCFP
• Dip Med (CUHK)

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Normal Heart Rate and The Danger of Abnormal Heart Rhythms

References

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