Harvard Women's Health Watch

What your heart rate is telling you

Your pulse, both at rest and during exercise, can reveal your risk for heart attack and your aerobic capacity.

Your grandmother may have referred to your heart as "your ticker," but that nickname has proved to be a misnomer. A healthy heart doesn't beat with the regularity of clockwork. It speeds up and slows down to accommodate your changing need for oxygen as your activities vary throughout the day. What is a "normal" heart rate varies from person to person. However, an unusually high resting heart rate or low maximum heart rate may signify an increased risk of heart attack and death.

"One simple thing women can do is to check their resting heart rate. It's a fairly easy to do, and having the in-formation can help down the road," says Dr. Paula Johnson, a cardiologist and chief of the Division of Women's Health at Harvard-affiliated Brigham and Women's Hospital. It's a good idea to take your pulse occasionally to get a sense of what's normal for you and to identify unusual changes in rate or regularity that may warrant medical attention.

Average heart rates by age

Age in years

Average maximum heart rate in beats per minute

Target heart rate range in beats per minute

40

180

90 to 153

45

175

88 to 149

50

170

85 to 145

55

165

83 to 140

60

160

80 to 136

65

155

78 to 132

70

150

75 to 128

Source: American Heart Association.

Your resting heart rate

When you are at rest, your heart is pumping the lowest amount of blood to supply the oxygen your body's needs. For most healthy women, resting heart rates range from 60 to 100 beats per minute. However, a 2010 report from the Women's Health Initiative (WHI) indicated that a resting heart rate at the low end of that spectrum may offer some protection against heart attacks. When WHI researchers examined data on 129,135 postmenopausal women, they found that those with the highest resting heart rates—more than 76 beats per minute—were 26% more likely to have a heart attack or die from one than those with the lowest resting heart rates—62 beats per minute or less. If your resting heart rate is consistently above 80 beats per minute, you might want to talk to your doctor about how your heart rate and other personal factors influence your risk for cardiovascular disease.

Your maximum heart rate

The rate at which your heart is beating when it is working its hardest to meet your body's oxygen needs is your maximum heart rate. Your maximum heart rate plays a major role in setting your aerobic capacity—the amount of oxygen you are able to consume. Several large observational studies have indicated that a high aerobic capacity is associated with a lower risk of heart attack and death. And a small controlled trial demonstrated that men and women with mild cognitive impairment who raised their aerobic capacity also improved their performance on tests of memory and reasoning.

The role of exercise

Vigorous exercise is the best way to both lower your resting heart rate and increase your maximum heart rate and aerobic capacity. Because it's impossible to maintain a maximum heart rate for more than a few minutes, physiologists have advised setting a percentage of your maximum heart rate as a target during exercise. If you're starting an exercise program, you may want to set your target rate at 50% of maximum and gradually increase the intensity of your workout until you reach 70% to 80%.

However, if you don't exercise regularly, you should check with your doctor before you set a target heart rate. Some medications—particularly beta blockers—can lower your heart rate. Your doctor can help you set realistic goals.

How to take your pulse

Although you may be able to feel your blood pumping in a number of places—your neck, the inside of your elbow, and even the top of your foot—your wrist is probably the most convenient and reliable place to get a good pulse.

Press your index and middle fingers together on your wrist, below the fat pad of your thumb. Feel around lightly until you detect throbbing. If you press too hard you may suppress the pulse. You can probably get a pretty accurate reading by counting the number of beats in 15 seconds and multiplying that number by four, Dr. Johnson says.

The best time to get your resting heart rate is first thing in the morning, even before you get out of bed. To gauge your maximum heart rate, take your pulse immediately after exercising as vigorously as possible.

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