Does a slow resting pulse mean you don’t have heart disease?

Think again if you believe your slow resting heart rate means you can’t possibly have heart disease – even severe heart disease, also known as coronary artery disease (CAD).

A heart with heavily clogged arteries can still have a consistent beat of 60-something or 70-something per minute.

“A low resting heart rate does not preclude CAD, nor does a low blood pressure,” says Dr. Michael Fiocco, Chief of Open Heart Surgery at Union Memorial Hospital in Baltimore, Maryland, one of the nation’s top 50 heart hospitals.

“The vast majority of coronary disease patients are hypertensive (high blood pressure), but those with normal or low blood pressure are not protected.”


I’ve witnessed this myself, in that my mother’s resting heart rate was consistently in the high 60s, sometimes into the 70s, yet she ended up needing quintuple bypass surgery after a catheter angiogram revealed five major coronary arteries to be almost completely blocked.

She had the “slow” resting heart rate right up to the time of surgery.

Almost daily she’d take her blood pressure at home with a little device, and it would show resting heart rate. Her blood pressure was also consistently in the normal range.

Between the slow or “normal” resting heart rate, and the normal blood pressure, my mother was convinced she couldn’t possibly have heart disease.

Dr. Fiocco explains, “Although a low resting heart rate has in the past been a marker of someone who was healthy and fit, a much better measurement is what is called your recovery heart rate.

“In other words, how quickly your heart rate returns to normal after maximum exercise. ijeab

“If your heart rate drops more than 30 beats, and in the most fit, 50 beats, within two minutes of stopping max exercise, you are considered healthy and at low risk for CAD.”

My mother’s resting heart rate was slower than mine, but pre-surgery she’d get audibly out of breath simply by hurrying to answer the phone in another room; whereas I could sprint across a parking lot in the rain, my baseline heart rate faster than my mother’s.

Yet at the conclusion of the sprint, my heart rate would hardly be elevated and I would not be out of breath.

“Back to the low or normal blood pressure patients,” continues Dr. Fiocco.

“Most are taking better care of themselves, and are less likely to have CAD.

“But there are exceptions and we see patients all the time with normal blood pressure who smoke and have diabetes or a strong family history of CAD, who themselves have CAD.”

Don’t let that slow resting heart rate or low blood pressure fool you; this does not mean you can’t have heart disease!

dr. fiocco

Dr. Fiocco specializes in treating artery disease, valvular disease and aortic aneurysm. His heart care expertise has earned him recognition by Baltimore Magazine as a Top Doctor in 2010, 2011, 2013, 2016 and 2017.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


Top image credit: Szlomo Lejb