Resting heart rate and wearable technology

Zhang and colleagues have reported a well-conducted meta-analysis describing the association between resting heart rate and all-cause and cardiovascular mortality in the general population.1 They found an increased risk of mortality in patients with a resting heart rate even within the normal range (60 to 100 beats/min). Although there is little clinical data on the benefits of heart rate reduction in otherwise healthy patients free of cardiovascular risk factors or disease, this study may provide valuable information to engage and empower patients.

There is a clear increase in the popularity of wireless heart rate monitors, fitness trackers and wearable body sensors.2 Patients are using these devices for a variety of reasons, such as to track the number of steps taken per day and sleep quality, but they also use them to monitor heart rate. Physicians are being asked by patients to interpret the heart rate data logged by their wearable technology. Because these devices are not medical grade, questions about their data are often dismissed by clinicians. We believe this is a missed opportunity to engage and collaborate with the patient.

Patients who use a wearable device have taken a voluntary step toward improving their health. Dismissing questions about the heart rate data tracked by their device may deter patients from taking these initiatives. Although resting heart rate is influenced by various factors, long-term physical fitness, especially endurance training, is associated with a lower resting heart rate.3 Zhang and colleagues’ study findings may be informative to patients and open the dialogue to discuss safe and appropriate fitness goals, counsel on other lifestyle changes and provide overall encouragement and support. Physicians should still confirm resting heart rates with medical grade equipment and inform patients that heart rate reductions in otherwise healthy patients have not been proven to lower risk. But for now, it appears that the lower the resting heart rate the better.