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Last updated January 20, 2017 (originally published October 6, 2012)
By A. Turner, Featured Columnist

We often hear about making sure our heart rate doesn't get too high --
but is it possible for our pulse to be too low?  The 2011 National Health
Statistics Reports publishes that 15.2% of adult males and 6.9% of
adult females in the U.S. have "abnormally slow heart rate,"  also
known as "bradycardia".  What does it mean to have bradycardia, and
how can we prevent it?

When our heart rate is too low, it may be a type of arrhythmia, a
disorder of the pulse: bradycardia is the more specific term for an
arrhythmia that is too slow. The rate of our hearts can tell us many
things about our health, indicating our level of fitness, medical
conditions, and even how hydrated we are : we just have to know how
to read the signs.

How Slow is Too Slow?  

The National Institutes of Health report that normal, healthy heart rates
for children should not be less than 70 beats per minute, and that
adults should not pulse much lower than 60 beats per minute -- that is,
except for well-trained athletes, whose heart may pump at a strong,
slow 40 beats per minute.   Indeed, some studies show that a slow
heart rate offers many health benefits -- depending on the fitness and
health of the heart in question.

A Slow Heart Rate Can Be a Good Sign.

A slower heart rate may improve your health, not decrease it. A slow
heart rate might not be a bad thing: to the contrary, it could help to
prolong your life.

In 2008, Dr. Xavier Jouven at the Paris Cardiovascular Research
Center, along with experts from other institutions in France,  looked at
how heart rate is related to mortality as we age.  

The team observed over 5,000 men without heart problems
("asymptomatic working men") between the ages of 42 and measured
their heart rates at rest for five consecutive years.  

Twenty years after the study, over 1,200 of the subjects died.  The
data showed that subjects with decreased heart rates over the five
year study period had a "14% decreased mortality risk," while men
whose heart rates had increased had a "19% increased mortality risk."

So if you think your heart rate might be too slow, don't panic!  Your
seemingly sluggish pulse might be a blessing in disguise.

[Editor's Note:

Dr. Jouven led a prior study in 2001 which showed that maintaining a
resting heart rate at 60 or below confers significant protection against
sudden death from heart attack.  This type of heart rate would be
consistent with a healthy lifestyle of regular exercise, no smoking and a
diet with plenty of vegetables and fruit. The study examined the heart
rates and health profiles of 7,746 men between the ages of 42 and 53
years over a period of 23 years.]

Health Benefits and Slow Pulse  

The National Institutes of Health reports that well-trained athletes may
have a pulse as low as 40 to 60 beats per minute : If athletes have a
slow pulse, it must be a good thing, right?  It turns out that a slow
pulse could lead to other health benefits, too, in addition to making us
feel like fit stars.

In 2011, a large team of doctors from various institutions in Germany,
including Dr. Florian Custodis with the Clinic of Internal Medicine at the
University of Saarlandes in Homburg,  investigated how heart rate
indicated, or affected, chronic stress -- on nearly 13,000 mice, who
underwent "chronic stress protocol for 28 days."  

They found that stress did increase heart rate, and that "endothelium-
dependent relaxation of aortic rings' was also impaired during stress
(the endothelium is a layer of cells that line the heart, blood and lymph
vessels).   The negative affects due to stress were improved upon by
heart rate reduction, so that the team concludes that heart rate
reduction "protects cerebral ischemia via improvement of endothelial
function and reduction of oxidative stress."  Heart rate can be, they
judge, "a mediator of vascular effects induced by chronic stress."

If you're worried about the stresses in your life reaching your heart,
try focusing on your heart rate -- read below for ideas on how to do

How to Get a Slow Pulse.  You can lower your pulse be exercising, or
taking drugs like Ivabradine  -- or,  you could consume fish oil.

In 2009, a team of experts in the Netherlands, including Dr. Arie
Verkerk with the Heart Failure Research Center at the University of
Amsterdam, studied how fish oil influenced heart rate and pacemaker
activity.  Rabbits were fed a diet enriched with either 2.5% fish oil,
2.5% sunflower oil, or control, for three weeks, during which time
heart rate and pacemaker activity was measured.  

Results showed that fish oil "significantly prolonged the cycle length" of
heart beat, partially because fish oil reduced the pacemaker current by
nearly 30%.  The team suggests that fish oil could be a more natural
treatment instead of drugs that lower pacemaker current, and thus
serve as well as a heart-rate reducer.

You may have heard horror stories of fish-oil burps: but maybe a fishy
taste in the mouth is worth the effect it has on our heart.

What if my heart rate is too low?

When all is good and well with our hearts, they pump blood to the
lungs and to the rest of the body with the help of an electrical system
that regulates the heart’s contractions.  This electrical system is
composed of the sinoatrial node, also known as our natural pacemaker,
a determined electrical pathway, and nerve signals that tell the heart to
beat faster or slower.  An arrhythmia occurs when a problem arises in
this electrical system, and could be either an irregular quickening of the
pulse (tachycardia), or an irregular slowing (bradycardia), or an
irregular combination of the two.  

Other symptoms of arrhythmia may include chest pain, fainting,
dizziness, paleness, and shortness of breath.   What follows is a list of a
few causes of bradycardia arrhythmias.  

Myocarditis and Bradycardia.

The poet may swoon that her lover makes her heart swell, there may
be little that is romantic about such a condition.  The swelling or
inflammation of the heart muscle is also known as myocarditis, and is
mostly caused by viral, fungal, or bacterial infections that reach the
heart.  The heart inflames under these conditions, because the immune
system releases chemicals to fight off the disease, chemcials that may
enter the heart and damage the muscle.  Symptoms of myocarditis may
be similar to the flue, and may also include leg swelling, fever, and
chest pain that resembles a heart attack.

In 2011, Dr. Katrina Iverson with Pediatric Emergency Medicine at
Children’s Hospital of Michigan, along with colleagues  encountered a
13 year old female in the emergency room who had experienced three
days of “subjective fever, upper respiratory symptoms, and fatigue.”  
She was soon discovered to have “severe bradycardia secondary to
complete heart block” that, along with other factors, resulted in
“multisystem organ failure.”  After much testing, the patient was
determined to have viral myocarditis, perhaps better described as
inflammation of the heart.  She was treated with “transthoracic pacing”
and “emergent transvenous pacing.”

If you experience any of the above symptoms, seek professional care
as soon as you can: we all know how painful it is when our swelling
hearts don't get the attention that they need.

The Not-so-common Flu and Slow Heart Rate.

Sometimes the flu makes us want to curl up in a ball and stop working:
sometimes our hearts couldn't agree more.

In 2011, Yoshihito Otsuka with the Department of Laboratory Medicine
at the Kameda Medical Center in Kamogawa, Japan, along with a team
of colleagues,  encountered a 36 year old man with fever and general
fatigue.  The patient was diagnosed with influenza, and lab results led
to diagnosis of influenza pneumonia.  After treatment with mechanical
ventilation, the patient showed bradycardia along with other
symptoms, so that he was this time diagnosed with “influenza
myocarditis,” a combination that is “regarded as rare by physicians.”  
Despite the scarcity of bradycardia’s being coupled with myocarditis,
the authors warn  that the latter “could cause fatal arrhythmia and
heart failure,” so that “all clinicians should be aware of the overall
clinical picture and the possibility of severe complications of myocarditis
caused by flu infection.”

Sometimes the flu is not just the flu.

6.  Dengue Fever Can Cause Slow Heart Rate.

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Fish oil can cause a slow heart pulse.