What Your Resting Heart Rate is Trying to Tell You
By: Brian Hoeflinger, MD
May 31, 2026 | #87
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Disclaimer: Opinions are my own. Not medical advice.
Medical Trivia of the Week
A very fit endurance athlete and an untrained person can have the exact same resting heart rate at rest. So what actually makes the athlete's heart more efficient? (the correct answer is at the end of this email)
- A) Their heart beats with more force per contraction, pumping more blood per beat
- B) Their blood carries more oxygen per red blood cell
- C) Their arteries are physically wider
- D) Their heart has more chambers active during rest
The Number You Already Have but Rarely Read
Most people will spend money on bloodwork, scans, and supplements before they ever pay attention to a number their own body produces every second of every day. Your resting heart rate. It costs nothing to check, it takes about thirty seconds, and over time it can tell you more about your health than almost any single measurement you can take at home.
I find that a good amount of people have no idea what their resting heart rate actually is. They might know it vaguely from a smartwatch notification, but they have never stopped to ask what the number means or whether it is a good one. That is a missed opportunity, because few things give you this much insight for this little effort.
What Resting Heart Rate Actually Measures
Your resting heart rate is simply the number of times your heart beats per minute while you are awake, calm, and at rest. For most adults, a normal resting heart rate falls somewhere between 60 and 100 beats per minute.
But here is the part that matters. Within that normal range, lower is generally better. A resting heart rate in the 40s or 50s usually signals a heart that is strong and efficient, one that can move the blood your body needs without having to work very hard. A resting heart rate consistently pushing toward the high end, in the 80s or 90s, means your heart is doing more work just to keep you idling.
Think of it like the engine of a car at a stoplight. A well-tuned engine idles low and quiet. An engine that is straining idles high and loud. Your heart is no different. Over the course of a lifetime, a heart beating 80 times a minute racks up tens of millions more beats per year than a heart beating 50 times a minute. That difference adds up.
What Quietly Pushes Your Number Up
When your resting heart rate climbs over time, it is rarely random. It is usually your body responding to something. The most common drivers are the ones hiding in plain sight in everyday life.
Poor cardiovascular fitness. The less conditioned your heart is, the harder it has to work to do the same job. This is the most common reason for a higher resting rate, and the most fixable.
Chronic stress. When stress hormones stay elevated, your heart rate stays elevated with them. A persistently high resting rate is sometimes the first physical sign that your nervous system has been running hot for too long.
Poor sleep. A single bad night can raise your resting heart rate the next day. Months of bad sleep can keep it elevated as a baseline.
Dehydration, alcohol, and caffeine. All three make the heart work harder to maintain normal circulation. Alcohol in particular tends to raise resting heart rate for hours after drinking, often well into the next morning.
Certain medications and medical conditions. Thyroid problems, anemia, infections, and some medications can all raise resting heart rate, which is one reason a sudden unexplained change is worth a conversation with your doctor.
Why the Trend Matters More Than the Number
Here is what I want you to take away more than anything else. A single resting heart rate reading tells you a little. The trend over weeks and months tells you a lot.
If your resting heart rate has slowly been creeping upward over the past year, that is information. It may be reflecting weight gain, rising stress, declining fitness, or worsening sleep. If it has been drifting downward as you exercise more and sleep better, that is your body confirming that what you are doing is working.
This is the real value of the modern fitness tracker. Not the single reading it shows you in the morning, but the line it draws over months. A resting heart rate that jumps five or ten beats above your normal baseline and stays there is often one of the earliest signals that something has changed, sometimes before you feel any symptoms at all. Illness, overtraining, and burnout frequently announce themselves this way first.
How to Measure It Properly
If you want an accurate number, the best time to check is first thing in the morning, before you get out of bed and before any coffee. Most smartwatches / smart rings show you this information so check your specific smartwatch / smart ring if you have one.
Alternatively, you can check your resting heart rate manually. Lie still, find your pulse at your wrist or the side of your neck, count the beats for thirty seconds, and multiply by two.
Do this for a few mornings and take the average. One reading can be thrown off by a stressful dream or a full bladder. A few readings together give you your true baseline, and that baseline is the number worth tracking over time.
How to Bring It Down Over Time
The encouraging part is that resting heart rate is one of the most responsive numbers in your body. With consistent effort, most people can lower it meaningfully within a few months.
Move your body regularly. Aerobic exercise is the single most effective way to lower resting heart rate. Walking, cycling, swimming, and jogging all strengthen the heart so it can pump more blood with each beat, which means fewer beats needed overall.
Protect your sleep. Consistent, quality sleep allows your nervous system to recover and your resting rate to settle.
Manage stress deliberately. Even a few minutes a day of slow, deep breathing can lower heart rate in the moment and, practiced regularly, over the long term.
Stay hydrated and go easy on alcohol. Both make a measurable difference, often faster than people expect.
None of this requires a gym membership or a complicated protocol. It requires consistency. And your resting heart rate will quietly keep score, showing you the progress before the mirror or the scale ever will.
Your heart beats about 100,000 times a day whether you pay attention or not. Spending thirty seconds to listen to it now and then may be one of the simplest health habits you ever build.
Impactful Quote of the Week
"Knowing yourself is the beginning of all wisdom."
- Aristotle
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All my best,
Brian Hoeflinger
P.S. - if you enjoyed this newsletter, you may enjoy my book that details my life as a neurosurgeon and the loss of my oldest son, Brian (see below a synopsis) and/or my podcast where I explain topics in further detail.
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https://doctorhoeflinger.com/products/the-night-he-died-the-harsh-reality-of-teenage-drinking
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Medical Trivia Answer:
The correct answer is A) Their heart beats with more force per contraction, pumping more blood per beat. This is called stroke volume. A trained heart pushes out more blood with every single beat, so even when the beats-per-minute number looks identical at rest, the athlete's heart is moving more blood with less total effort. It is efficiency, not just speed.
*Disclaimer: This newsletter and blog is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this newsletter and blog or materials linked from this newsletter and blog is at the user’s own risk. The content of this newsletter and blog is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard or delay seeking medical advice for any medical condition they may have and should consult their healthcare professionals for any such conditions.
