EvidenceBModerateGood evidence in people with one real weakness. New studies could change the answer.
Yes. A faster resting heart rate is linked to a higher risk of early death, and the link holds in many large studies. Whether the heart rate itself causes the extra risk is unclear.
Who it's for
Adults wanting a rough risk marker; it can't predict any one person's future.
What to expect
Each 10 beats a minute faster is linked to about 9% higher risk of death.
Watch out for
A link in observational studies doesn't prove a fast pulse causes early death.
Faster resting heart rate goes with higher death risk
Each dot is a risk ratio for dying from any cause, with a line for its 95% range, comparing faster resting heart rates with the lowest group.
← BetterWorse →
No difference
Heart rate 60 to 80 beats/min1.12 (1.07 to 1.17)Clear worsening
Heart rate over 80 beats/min1.45 (1.34 to 1.57)Clear worsening
11.5
risk of death vs. lowest rate, 1 = same
Faster resting heart rate goes with higher death risk
A review that pooled 46 studies following about 1.2 million people found each 10 beats a minute increase was linked to a 9% higher relative risk How much more or less likely something is in one group than another, as a ratio. A big relative change can still be a small change for any one person. of death from any cause and 8% higher for heart disease death. People above 80 beats a minute had about a 45% higher relative risk of death than those with the lowest rates. Results varied a lot between studies, and publication bias was detected1Meta-analysis · 2016 · 320 peopleResting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis.Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population.CMAJ.
A second review of 87 studies found a 17% higher relative risk of death from any cause per 10 beats a minute. It also found links with heart failure, stroke and cancer. Results differed widely between studies2Meta-analysis · 2017 · 48 peopleResting 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.This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate.Nutr Metab Cardiovasc Dis.
A study pooling 12 cohorts of 112,680 people in Asia and the Pacific, followed for about 7 years, found a link above roughly 65 beats a minute and none below it. People at 80 or more had about 54% higher relative risk of death than those under 655Meta-analysis · 2014 · 112,680 peopleThe association between resting heart rate, cardiovascular disease and mortality: evidence from 112,680 men and women in 12 cohorts.RHR of above 65 beats/min has a strong independent effect on premature mortality and stroke, but a lesser effect on CHD. Lifestyle and pharmaceutical regimens to reduce RHR may be beneficial for people with moderate to high levels of RHR.Eur J Prev Cardiol.
In people with heart failure, a review of 62 studies (163,445 people) linked each 10 beats a minute increase to 10% higher relative risk of death. The link was rated high quality6Meta-analysis · 2021 · 163,445 peopleResting Heart Rate as an Important Predictor of Mortality and Morbidity in Ambulatory Patients With Heart Failure: A Systematic Review and Meta-Analysis.High-quality evidence demonstrates increasing resting heart rate is a significant predictor of all-cause mortality in ambulatory patients with heart failure on optimal medical therapy, with consistent effect across most patient factors and an increased risk trending with older age.J Card Fail. Similar patterns appeared in people with coronary artery disease3Randomized trial · 2005 · 913 peopleLong-term prognostic value of resting heart rate in patients with suspected or proven coronary artery disease.Resting heart rate is a simple measurement with prognostic implications. High resting heart rate is a predictor for total and cardiovascular mortality independent of other risk factors in patients with CAD.Eur Heart J,8Randomized trial · 2008 · 2,745 peopleHeart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial.In patients with coronary artery disease and left-ventricular systolic dysfunction, elevated heart rate (70 bpm or greater) identifies those at increased risk of cardiovascular outcomes, with a differential effect on outcomes associated with heart failure and outcomes associated with coronary events.Lancet.
Long-running studies of healthy-at-start adults, such as Framingham (5,070 people, 30 years), found death rates rose steadily with heart rate7Observational study · 1987 · 5,070 peopleHeart rate and cardiovascular mortality: the Framingham Study.There was also a substantial excess of noncardiovascular deaths at high heart rates, and the proportion of all deaths resulting from cardiovascular disease did not increase with heart rate. The excess cardiovascular deaths with more rapid heart rates were also noted, excluding those with interim overt cardiovascular…Am Heart J. A Chicago study over 22 years found the link in younger men and middle-aged men and women, but not in women aged 18 to 3910Observational study · 1999 · 9,706 peopleResting heart rate is a risk factor for cardiovascular and noncardiovascular mortality: the Chicago Heart Association Detection Project in Industry.Heart rate was not associated with mortality in women aged 18-39 years. In summary, heart rate was a risk factor for mortality from coronary disease, all cardiovascular diseases, and all causes in younger men and in middle-aged men and women, and for cancer mortality in middle-aged men and women.Am J Epidemiol.
Genetic analysis of up to 835,465 people found no evidence that a genetically higher heart rate raises the risk of death. The authors say earlier positive genetic findings were probably false positives4Meta-analysis · 2023 · 835,465 peopleGenetic insights into resting heart rate and its role in cardiovascular disease.Systematic alteration of key differences between the current and previous Mendelian randomization study indicates that the most likely cause of the discrepancy between these studies arises from false positive findings in previous one-sample MR analyses caused by weak-instrument bias at lower P-value thresholds. The…Nat Commun. This suggests part of the observational Studies that watch what happens to people rather than assigning a treatment. They can show links, not cause and effect. link may reflect other factors, such as illness or fitness.
These figures compare groups, so the gain or loss for one person depends on how high their risk was to begin with.
Key studies
Study
Who
What it found
Review of 46 studies, 20161Meta-analysis · 2016 · 320 peopleResting heart rate and all-cause and cardiovascular mortality in the general population: a meta-analysis.Higher resting heart rate was independently associated with increased risks of all-cause and cardiovascular mortality. This indicates that resting heart rate is a predictor of all-cause and cardiovascular mortality in the general population.CMAJ
About 1.2 million general-population adults
9% higher relative risk of death per 10 beats a minute
Review of 87 studies, 20172Meta-analysis · 2017 · 48 peopleResting 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.This meta-analysis found an increased risk of coronary heart disease, sudden cardiac death, heart failure, atrial fibrillation, stroke, cardiovascular disease, total cancer and all-cause mortality with greater resting heart rate.Nutr Metab Cardiovasc Dis
Adults in cohort studies Researchers follow a group of people over time without giving them a treatment. It can show links, not cause and effect.
17% higher relative risk of death per 10 beats a minute
Pooled 12 cohorts, 20145Meta-analysis · 2014 · 112,680 peopleThe association between resting heart rate, cardiovascular disease and mortality: evidence from 112,680 men and women in 12 cohorts.RHR of above 65 beats/min has a strong independent effect on premature mortality and stroke, but a lesser effect on CHD. Lifestyle and pharmaceutical regimens to reduce RHR may be beneficial for people with moderate to high levels of RHR.Eur J Prev Cardiol
112,680 adults in Asia-Pacific
Risk rose above about 65 beats a minute
Review of 62 studies, 20216Meta-analysis · 2021 · 163,445 peopleResting Heart Rate as an Important Predictor of Mortality and Morbidity in Ambulatory Patients With Heart Failure: A Systematic Review and Meta-Analysis.High-quality evidence demonstrates increasing resting heart rate is a significant predictor of all-cause mortality in ambulatory patients with heart failure on optimal medical therapy, with consistent effect across most patient factors and an increased risk trending with older age.J Card Fail
163,445 people with heart failure
10% higher relative risk of death per 10 beats a minute
Genetic analysis, 20234Meta-analysis · 2023 · 835,465 peopleGenetic insights into resting heart rate and its role in cardiovascular disease.Systematic alteration of key differences between the current and previous Mendelian randomization study indicates that the most likely cause of the discrepancy between these studies arises from false positive findings in previous one-sample MR analyses caused by weak-instrument bias at lower P-value thresholds. The…Nat Commun
Up to 835,465 people
No genetic link with death from any cause
What we don't know
Whether lowering a resting heart rate in healthy people lowers their risk of death.
Why the genetic analysis and the observational studies disagree.
Written by AI from the studies listed, without review by a clinician, and graded with the GRADE method. It can be wrong, so check the studies it cites. Education, not medical advice.