Resting heart rate and the risk of dying

Every 10 beats per minute faster at rest is linked to about a 17% higher risk of dying, from any cause, in a combined analysis of 48 studies (Aune 2017).

Read your number

Is my resting heart rate good?

Measure at complete rest and read the number in context. Zhang 2016 studied the association between resting heart rate and death rates in the general population. This makes pulse a useful readout; it does not establish a treatment target. Focus on aerobic fitness, sleep and recovery. A watch reading can differ from the measurements used in the studies.

If you're 70 or older

At 70 and older, bring the reading and your medication context to your clinician if you are deciding what it means for you. The existing evidence notes distinguish a low pulse from fitness from one related to illness or rate-limiting medication. Keep your focus on fitness and recovery, with treatment decisions made with your clinician.

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Evidence already on this page: Zhang et al. 2016; Fox et al. (SIGNIFY) 2014.

Where you stand

Aune 2017 is the largest combined estimate, at 17% per 10 beats. Near 60–80 this score is shallower than that headline, because it follows a different paper in that range.

A lower resting heart rate goes with lower risk, and the climb gets steeper above 80 beats a minute.

At 78 bpm1.08×a typical 45-year-old’s risk, a little higher than typical.

See the same numbers as a table

Resting heart rate and risk of death from any cause, as a multiple of a typical 45-year-old’s risk
Beats per minute at rest	Risk vs typical	In words
40 bpm	0.85×	lower than typical
60 bpm	0.90×	a little lower than typical
70 bpm	1.00×	about the same as typical
80 bpm	1.10×	a little higher than typical
100 bpm	1.40×	higher than typical
120 bpm	1.60×	much higher than typical

Risk of death from any cause, with every other marker held at typical. Drag the marker or use the arrow keys. Nothing you move here is saved.

The study reports one steady rate per 10 beats. The steeper climb above 80 and the flat stretch from 40 to 50 are the model’s own choices. A low pulse from illness, overreaching, or a rate-limiting drug is not the same finding as a low pulse from fitness.

Source: Zhang et al. 2016, CMAJ (PMID 26598376)

The study, not the score

each 10 bpm higher resting heart rate

Zhang et al. 2016

1.09 (1.07–1.12)

9% higher all-cause mortality

The bar shows the study’s 95% confidence interval, the range of values consistent with its data. The tick is the study’s best single figure. The centre line is no difference. The chart above is the score’s own curve, not this study.

What it is

Beats per minute at complete rest. Most watches already report the number. Resting heart rate was measured in Zhang’s included studies; a phone or watch reading can differ from those study measurements.

How the score uses it

Technical notes

The curve is a constructed smooth curve (70 bpm = 1.0; 40–50 floor 0.85; 60 = 0.90). Zhang’s 2016 synthesis is about 10 years old. Near 60–80 bpm it tracks Zhang 2016’s general-population all-cause mortality RR 1.09 (1.07–1.12) per 10 bpm (46 studies; 1.25 million people; I² 92.3%) — that is a relative risk, not a hazard ratio, and it is an association, not a treatment effect. Zhang’s trim-and-fill for publication bias is RR 1.04 (1.02–1.06). all-cause mortality versus 45 bpm is linear (p nonlinearity = 0.1); the 90 bpm mark is cardiovascular mortality, not an all-cause cliff. Above 80 the curve steepens past Zhang’s linear slope (1.25 at 90 vs ~1.19) — a disclosed departure from the source shape. The 40–50 bpm side departs the same way in the opposite direction: the curve pins both to an identical 0.85 floor, while Zhang’s own spline reads linear through that low zone (p nonlinearity = 0.1), which argues 40 and 50 bpm should not score the same. That range could not be confirmed from Zhang’s full text (cmaj.ca returned 403). Main source: Zhang. Supporting: Aune 2017 (larger all-cause mortality pool RR 1.17 per 10 bpm, mixed prospective) / Raisi-Estabragh 2020 (UKB per 10 bpm all-cause mortality 1.22 men / 1.19 women) / Custodis 2016 (≥70 vs <70 all-cause mortality 1.68, coronary events NS; marker, not a rate-lowering trial).

How to improve it

Build aerobic fitness: in trials in healthy people, regular exercise, especially endurance training and yoga, lowered resting heart rate (Reimers 2018); those trials do not show that lowering the number changes deaths
Prioritize sleep and keep caffeine earlier in the day
Practice breathing or meditation for recovery

What the studies found

Endpoint	Grade	Finding
—	METHOD	smooth curve is constructed (70 bpm = 1.0) Technical notes Anchor points 40/50 = 0.85, 60 = 0.90, 70 = 1.0, 80 = 1.10, 90 = 1.25, 100 = 1.40, 120 = 1.60. Near 60–80 this is ~Zhang’s +9%/10 bpm. Two disclosed departures from Zhang’s own spline: above 80 the curve steepens past Zhang’s linear slope, and below 60 the 40/50 bpm anchor points are pinned to an identical 0.85 floor even though Zhang’s spline reads linear through that low zone (p nonlinearity = 0.1) — that range could not be confirmed against Zhang’s full text (cmaj.ca returned 403).
All-cause mortality	B	Zhang 2016 is RR 1.09, not an HR Technical notes General-population all-cause mortality RR 1.09 (1.07–1.12) per 10 bpm. Trim-and-fill 1.04. 90 bpm is the CV spline vs 45 bpm — all-cause mortality is linear. Aune 2017 all-cause mortality RR 1.17 is the larger pool. Custodis: ≥70 bpm predicts all-cause mortality, not coronary events.
All-cause mortality	B	1.22 / 1.19 in UK Biobank (Raisi-Estabragh 2020) Technical notes Single cohort, 502,534 UK Biobank adults, seated Omron pulse (mean of two readings) — closer to a home reading than Zhang’s mixed ECG pool. Fully adjusted all-cause mortality HR per 10 bpm: 1.22 (1.20–1.24) in men, 1.19 (1.16–1.22) in women, both higher than Zhang’s pooled 1.09.
All-cause mortality	B	1.17 Per 10 bpm, a Larger Pool (Aune 2017) Technical notes Larger dose-response meta than Zhang: 48 studies pooled all-cause mortality RR 1.17 (1.14–1.19) per 10 bpm, I² 94.0%. The high-vs-low contrast in the same paper was RR 1.69 (1.52–1.87) — both higher than Zhang’s pooled 1.09, from a broader prospective mix than Zhang’s general-population-only pool.
All-cause mortality, adults 30–59 (men and women)	C	Middle-Aged Adults Only (Okamura 2004) Technical notes Japanese general-population cohort of 8,800 adults followed 16.5 years. In middle-aged adults (30–59) the highest resting-heart-rate quartile carried higher all-cause mortality: men RR 1.45 (95% CI 1.06–2.00), women RR 1.94 (1.26–3.01). The authors report these relations were not evident in people 60 and older.
All-cause mortality	B	Predicts Death, Not Coronary Events (Custodis 2016) Technical notes Heinz Nixdorf RECALL cohort, 4,091 adults free of known CAD and off rate-lowering medication, median 10.5 years, 398 deaths: RHR ≥70 vs <70 bpm carried all-cause mortality HR 1.68 (1.30–2.18), and per 5 bpm all-cause mortality HR 1.13 (1.07–1.20) — but the same slices showed no significant association with coronary events (HR 1.20 and 1.02, both NS).

What argues against this

Raisi-Estabragh et al. 2020, a single UK Biobank cohort of 502,534 adults using seated Omron pulse readings — closer to a home reading than Zhang's mixed ECG pool — found a steeper all-cause mortality slope per 10 bpm than the curve's Zhang-anchored baseline: HR 1.22 (1.20–1.24) in men and 1.19 (1.16–1.22) in women versus Zhang's pooled 1.09. This argues the curve's near-baseline slope may understate resting-heart-rate risk rather than overstate it — a magnitude disagreement, not a directional one.

Last reviewed 12 October 2026

Sources

8 cited

Zhang et al. (2016) — CMAJ
Resting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis
View source
Aune et al. (2017) — Nutrition, Metabolism and Cardiovascular Diseases
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
View source
Raisi-Estabragh et al. (2020) — PLoS ONE
Age, sex and disease-specific associations between resting heart rate and cardiovascular mortality in the UK BIOBANK
View source
He et al. (2022) — Public Health
Relationship of resting heart rate and blood pressure with all-cause and cardiovascular disease mortality
View source
Okamura et al. (2004) — American Heart Journal
Resting heart rate and cause-specific death in a 16.5-year cohort study of the Japanese general population
View source
Custodis et al. (2016) — Clinical Research in Cardiology
Resting heart rate is an independent predictor of all-cause mortality in the middle aged general population
View source
Fox et al. (SIGNIFY) (2014) — New England Journal of Medicine
Ivabradine in stable coronary artery disease without clinical heart failure
View source
Reimers et al. (2018) — Journal of Clinical Medicine
Effects of Exercise on the Resting Heart Rate: A Systematic Review and Meta-Analysis of Interventional Studies
View source

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Educational content only — not medical advice, diagnosis, or treatment. Not a medical device; not FDA evaluated. Consult a qualified healthcare professional about your own health, and call emergency services for urgent symptoms. Full medical disclaimer →