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India, a nation on the treadmill

We have all observed that our heart rates are not constant at all times. It increases with physical activities like walking, running, and swimming. While the heart slips into the slower, steady pace known as the resting heart rate (RHR) when we are sitting or resting. However, an increase in the resting heart rate over time may be a signal of heart problem in the near future.

Elevated RHR is an independent risk factor for cardiovascular diseases (CVD) for healthy men and women, as the heart gets less time to relax (diastole) and receive its own blood supply from the coronaries. A strong, graded, independent relationship between RHR and incident cardiovascular disease has been demonstrated. Faster RHR is associated with shorter life expectancies. Elevated RHRs can increase the risk of mortality from CVD in particular.

Individual’s heart rate changes from minute to minute and it depends on the posture: either standing or lying down, moving around or sitting still and also on the mental state either stressed or relaxed. But individual’s RHR tends to be stable from day to day. The usual range for RHR is anywhere between 60-90 beats per minute. It keeps varying from person to person according to the time of the day, physical conditioning, environmental factors, sympathetic nervous system and vagal tone of the individual.

Indians, however, seem to be on a treadmill constantly, and Indians, as a race, seem to be in a race to catch up. According to the BEAT survey done in India, a cross-sectional study of the Resting Heart Rate in Young (18-55 years) hypertensive patients, showed that high average resting heart rate is 82 beats per minutes (BPM).

Indian hypertensives have both elevated RHR and BP. And elevated RHR is bad for the hypertensive heart as the demand goes up (also due to left ventricular hypertrophy) and supply goes down as coronaries fill in diastole and time for diastolic filling is reduced in patients with elevated RHR.

Measuring your resting heart rate (RHR), that is the number of heart beats per minute while you’re at rest, is the best evaluator of your heart functioning. Place the index and middle finger on the wrist just below the thumb or along either side of the neck and you can feel the pulse. Use your watch (if possible a stopwatch) to count the number of heart beats for 60 seconds. Repeat this counting for few times to have an accurate reading. A normal heart rate is between 60-100 heart beats per minute. Most healthy and relaxed persons have a resting heart rate below 80 heart beats per minute. Your resting heart rate is telling you something, so listen carefully to the beats.

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Dr. C. K. Ponde

Guest Author The author is a Consultant Cardiologist at Hinduja Hospital.

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