What Does My Heart Rate Say About My Health?

Updated on Feb 21, 2025 | Cardiology, Your Health

Mary Ann McLaughlin, MD

Your heart rate is the number of times your heart beats per minute. You may pay little to no attention to your heart rate, but it can give you vital insight into your health—and may even save your life.

In this Q&A, Mary Ann McLaughlin, MD, MPH, FACC, Medical Director of Cardiovascular Health and Wellness, Mount Sinai Fuster Heart Hospital, and Associate Professor of Medicine, Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, discusses the importance of heart rate, as well as how to monitor it.

What is a normal heart rate range?
The normal heart rate for an adult is between 60 and 100 beats per minute. The average is 72 beats per minute.

How can I measure my heart rate?
The easiest way to detect your heart rate (without a device) is to feel your pulse in your wrist or neck for 60 seconds. For a more accurate heart rate, you can purchase a device, such as a wearable fitness tracker (e.g., smart watch), which can monitor your heart rate during sleep (resting heart rate) and exercise.

What affects my heart rate?
Heart rate increases to deliver more oxygen to your muscles. With any physical activity, your heart rate will go up. In addition, anxiety or emotional stress can cause an increase in adrenaline leading to high heart rates, often called the “fight or flight” response.

Can I improve my heart rate, and how?
You can improve your resting heart rate with regular exercise, adequate sleep, a healthy diet, and avoiding too much caffeine.

When is it time to see a doctor?
If you notice a very strong thumping sensation in your chest, feel dizzy or light-headed or faint, you need to talk to a doctor. If you are sitting or relaxing, and your heart rate is more than 100 beats per minute, you should talk to your doctor. If you have a family member who is diagnosed with an arrhythmia or irregular heart rate, you should notify your doctor. One particular arrhythmia, which can run in families, is called atrial fibrillation, and it can lead to stroke.

What is atrial fibrillation, and how is it related to heart rate?
Atrial fibrillation is an irregular heart rhythm. Symptoms are palpitations or thumping in the chest. If a family member has a history of atrial fibrillation, your risk for it is higher, which is why you should speak to a doctor.

My heart rate is below 60 beats per minute. Is that bad?
Having a low heart rate is generally a good thing, and is common among athletes. In most cases, it means the heart and cardiovascular system are working efficiently. However, in rare cases, a low resting heart rate can be a sign that something is wrong, especially if it is unusual for you. If you feel dizzy, fatigued, out of breath, or feel pain in your chest, you should see a doctor.

Schedule an appointment with a primary care doctor.

How Does Caffeine Affect My Heart?

Feb 3, 2025 | Cardiology, Your Health

Mary Ann McLaughlin, MD

Caffeine is a naturally occurring stimulant found in many products, including soda, coffee, tea, energy drinks, chocolate, and even some ice creams. While caffeine is safe to consume in moderation, excessive caffeine can be harmful, especially to your heart.

In this Q&A, Mary Ann McLaughlin, MD, MPH, FACC, Medical Director of Cardiovascular Health and Wellness, Mount Sinai Fuster Heart Hospital, and Associate Professor of Medicine, Population Health Science and Policy at the Icahn School of Medicine at Mount Sinai, discusses the effects of caffeine on heart health and how much is safe to have.

How does caffeine affect my heart and blood pressure?
Caffeine is a central nervous system stimulant that makes your arteries squeeze more robustly, increasing blood pressure and heart rate.

What are the main health risks of caffeine?
When caffeine speeds up your heart rate, it increases your risk for developing an abnormal heart rate, known as arrhythmia, which in severe cases can lead to stroke. Additionally, too much caffeine increases nervousness, anxiety, and insomnia—and in rarer cases it can cause hallucinations, confusion, and some memory issues. It also speeds digestion, potentially causing gastrointestinal problems, including heartburn and loose stools. Caffeine is also addictive.

What are the health benefits of caffeine?
In addition to reducing drowsiness and making you more alert, caffeine can be useful for treating migraines and other headaches. There is also evidence that it can improve aerobic capacity. Many athletes take some amount of caffeine to improve performance.

How much caffeine is safe to have?
According to the CDC, 400 milligrams a day is considered safe for most adults. One eight ounce cup of coffee contains around 95 mg of caffeine, but can have anywhere from 25 to 500 mg, depending on how the coffee is processed, what beans are used in the coffee, etc. Generally, more than four cups of coffee a day could be harmful. Energy drinks can contain excessive amounts of caffeine and should be consumed in moderation, if at all.

Drinking coffee and other caffeinated drinks can become a habit. I recommend treating caffeine as a medication and paying attention to your intake. Low amounts are safe, but as you increase caffeine, your risk for developing heart problems and other health issues becomes more likely.

Schedule an appointment with a primary care doctor.

How Can I Develop a Healthy Eating Pattern?

Updated on Feb 26, 2024 | Cardiology, Diet and Nutrition, Your Health

Hypertension, cholesterol, diabetes, and obesity—these are all drivers for heart disease, the leading cause of death in the United States. Treating each individually often means seeing multiple specialists. But one thing is clear: If you reduce excess body fat with a healthy lifestyle, your cholesterol, blood pressure, and risk for diabetes or prediabetes will likely drop, and so will your risk for heart disease.

Jeffrey I. Mechanick, MD

Jeffrey I. Mechanick, MD

In this Q&A, Jeffrey I. Mechanick, MD, Professor of Medicine and Medical Director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Fuster Heart Hospital, explains how adopting a healthy eating pattern, rather than restrictive or fad dieting, can reduce your risk for heart disease and other chronic illnesses.

How do I know if I am at risk for heart disease?

Your body mass index (BMI) should be 18.5 to 24.9 (for Asian Americans, a healthy BMI is 18.5 to 22.9). Keep in mind that for some people, such as those who are more muscular or have a lot of swelling, BMI may not be accurate. Your goal should not be to lose weight but to be healthy and enjoy your life. Instead of going on a diet or eliminating certain foods or food groups, focus on developing a healthy eating pattern.

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What is a healthy eating pattern?

First, do not think about a single food as being good or bad. Rather, consider how the pattern of foods you eat over the course of 24 hours—the total aggregate of the foods and the nutrients that are in them—are affecting your risk for heart disease. A healthy eating pattern is one that reduces your risk.

How do I develop a healthy eating pattern?

Here is what I often tell my patients:

  • An ideal plate is a healthy food plate, the majority of which should consist of hi-fiber plants.
  • If you include meat, make sure it is lean meat.
  • Keep in mind that quantity (portion size) is not as important as the quality of the food (whole, high-fiber foods).
  • Try to get in at least five to seven servings of fresh fruits and vegetables (one serving fits in the palm of your hand), as well as beans, lentils, nuts, and whole grains, every day.
  • Include a good quality protein—such as poultry, fish, or vegetable protein such as beans and lentils—with every meal.
  • Avoid processed foods, and eat treats only on occasion.
  • Instead of baked goods, have whole grain breads or even Ezekiel breads, which are made out of sprouts and lentils (this will help you transition your eating pattern to those healthier whole grains).
  • Limit alcohol as much as you can—no amount is considered healthy.
  • Do not skip meals.

If you’re having trouble, seek out a professional, such your primary care physician, heart specialist, or registered dietitian, who can help structure an eating pattern for you to achieve a healthy weight.

Learn how to meal plan for heart health and weight management.

What should I look for in food labels?

Look for foods that are high in fiber but lower in calories, fat, sodium, and simple sugars. Be aware that these numbers are often listed on Nutrition Facts labels as “per serving” and not per the total amount in the food product.

Dietary fiber: The more fiber, the better. Both soluble and insoluble fiber are good for gut health and decrease your risk for chronic diseases, such as heart disease and cancer. Fiber also decreases appetite and helps you feel full, so you are not as tempted to snack on high-calorie foods.

Sodium: The official recommendations are to have only about two grams of sodium a day—roughly one teaspoon of table salt per day. If you are already at risk for heart disease, you may need to limit sodium even more.

Saturated fat, trans fats, and simple sugars: While the data on how much saturated fat is safe is unclear, you should stick to foods that have little to no saturated fat. Avoid trans fats and simple sugars—again, you can find the amount on the Nutrition Facts labels of packaged foods or just by looking up information online.

What should I look for in restaurant menus?

Here’s a trick I give my patients: Don’t ask for the menu. Research the restaurant online at a time when you’re not hungry (such as after a meal at home) and decide what you will eat before you go, or ask the server about specific items they might have—the fish of the day, lean proteins that are cooked without sauces, salads and raw or steamed vegetables, plant-based entrees and side dishes, and even berries for dessert. This way, you won’t be tempted by the less healthy options on the menu or enticing specials.

Will dietary supplements reduce my risk for heart disease?

There is really no need to take dietary supplements unless there is a medical reason. If you are following a healthy eating pattern, you will reduce your risk for deficiencies. If you have any question or doubt, definitely discuss it with your physician.

What else will help me reduce my risk for heart disease?

Get sufficient amounts of physical activity, including a mix of aerobic exercise and strength training, especially progressive resistance training. Sleep a minimum of seven hours a night. Do not smoke or do drugs, and reduce stress as much as possible. If you are overly worried or struggle with addiction, don’t delay—seek help from a mental health professional or counselor.

Learn how to create a weight loss program that works for you.
Learn more about Your Health.

“Like Turning Off a Light Switch”: Signs and Symptoms of Stroke

Updated on May 22, 2024 | Cardiology, Neurology, Vascular Health, Your Health

Slurred speech, an impaired gait, paralysis on one side of the face, arm, and/or leg—these are all signs of a stroke, especially if they appear suddenly. If you believe you or someone else is experiencing a stroke, call 911 immediately. Strokes are an emergency, and waiting can result in serious brain injury and even death.

Carolyn Brockington, MD

In this Q&A, Carolyn Brockington, MD, Director of the Stroke Center at Mount Sinai West and Mount Sinai Morningside, and Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai, discusses the signs and symptoms of a stroke, the difference between a stroke and a mini stroke, and why you must act fast.

What is a stroke?                                                                                                         

Simply put, stroke is an injury to the brain caused by a reduction of blood flow—for example, a blood vessel is blocked by a blood clot. Strokes are an emergency because there is a restricted time period—just a few hours—for people to come in for treatment, where doctors can try to administer certain therapies to improve blood flow in order for the affected part of the brain not to be injured.

What are the signs and symptoms?

The signs and symptoms from stroke have to do with how the brain is organized. Primarily, the left side of the brain controls the right side of the body, and the right side controls the left. Let’s say somebody is not getting enough blood flow on the left side of the brain, depending on the part of the brain affected, they might develop right-sided weakness or right-sided numbness, or difficulty speaking, or difficulty understanding speech, etc. If someone has a stroke on the left side of the brain in the back, they may have vision problems but they’ll be able to walk around and speak. If they have a stroke towards the front of the brain, they might have more of a language problem but no vision disturbance. While it’s very hard to tell people exactly what type of symptoms they would have, the appropriate thing is to understand that the symptoms are sudden, like turning off a light switch. Pay attention to balance, eyesight, face asymmetry, arm or leg movement, speech or language.

Who is most at risk?

Everyone is at risk for stroke. Most people think you only have to worry about stroke when you are old. The truth is that the incidence of stroke increases as we get older, because some of the risk factors or the medical conditions that we know that increase stroke increase over time—high blood pressure (hypertension), diabetes, heart disease, elevated cholesterol, etc. However, the most important thing to understand is that anybody can have a stroke at any age. The fact that stroke risks increase with age doesn’t mean it can only happen when you get older. There are different reasons people might have a stroke at different ages.

If I think I or someone else is having a stroke, what should I do?

If you or someone else is having a stroke, time is ticking, so call 911. As doctors, we say “time is brain,” meaning every minute that goes by it has been estimated that approximately 1.9 million brain cells are potentially dying. Emergency Medical Services will dispatch the ambulance, which will take you to the closest designated stroke center that has the ability to assess you in a timely fashion and provide the appropriate treatments. At the Mount Sinai Health System, all of our eight hospitals have been designated as certified stroke centers, meaning that we all have multidisciplinary teams to provide the appropriate therapy within the clinical guidelines for the acute treatment of stroke.

How will I be treated for an acute stroke?

Once you are in the emergency room, there is a lot that needs to be done in a very short period of time to make sure you are eligible for acute stoke treatment, including brain imaging and blood tests, etc. Afterwards, we may be able to administer certain therapies, for selected patients, within what we call the “therapeutic window.”

For example, for acute stroke, there’s treatment we give intravenously through the IV in the emergency department. If there is a big blockage of a blood vessel, we might be able go in and pull that clot out. The time period for the intravenous therapy is within three hours of symptom onset, and for some people we can extend it to four and a half hours. People who receive treatment earlier typically do better.

Am I having a stroke?

It’s important for everyone of all ages to know the signs and symptoms of a stroke.  F.A.S.T and B.E.F.A.S.T, acronyms used by many medical and health organizations, including the American Heart Association and the American Stroke Association, can help you quickly spot the common signs and symptoms of stroke.

B is for sudden loss of balance. Your gait is suddenly off balance, as if drunk or suddenly dizzy.
E is for sudden loss of vision in one or both eyes. You may also see double.
F is for an uneven face. You are experiencing sudden facial weakness or numbness on one side.
A is for arms or leg weakness. You can’t outstretch your arm or leg or keep it up, and there is a sudden weakness and/or numbness on one side of your body.
S is for slurred speech. Aside from slurred speech, you may not be able find the right words, or may have trouble understanding others.
T is for time. “Time is brain.” Don’t wait and hope symptoms go away—call 911.

Want to learn more about the warning signs of a stroke? Check out this interactive F.A.S.T. guide from the American Stroke Association.

Hispanohablantes: ¿Crees que alguien está sufriendo un derrame cerebral? Sea R.Á.P.I.D.O.

What’s the difference between a stroke and a mini stroke?

When people say “mini stroke,” they mean a transient ischemic attack, or TIA. “Transient” means brief; “ischemia” means reduction in blood flow; and “attack” means an event that is a shorter period of time where not enough blood gets to the brain and causes symptoms. An example might be that somebody is walking down the street, and suddenly, they feel their left arm and leg is heavy. They are having difficulty moving, they may have some difficulty walking, and then a few minutes later it goes away. Both stroke and TIAs are caused by an interruption of blood flow to the brain. The big distinction is that the TIA is a shorter period of time where not enough blood gets to the brain, so it doesn’t cause a permanent injury.

What should I do if I think I had a TIA?

Even if the symptoms resolve, a TIA is an emergency. Even though a TIA doesn’t result in an injury to your brain, we need to identify the cause. TIAs are warning signs that a stroke may be looming. If we can find that you have an artery narrowing or problems with your heart or your blood or blood pressure etc, that gives us the opportunity to try to address the issue before you have a stroke. TIAs and stroke are both considered emergencies and require fast treatment.

How can I decrease my risk for having a stroke?

There are a lot of risk factors for stroke, both modifiable and nonmodifiable. Nonmodifiable risk factors include age and family history of stroke. Modifiable risk factors include high blood pressure, heart disease, and diabetes. Hypertension (high blood pressure) is the number one reason why people have stroke and heart disease. The identification of high blood pressure, and modifying it, usually through adopting a healthier diet, regular activity, and sometimes medication, is important. Speaking to your doctor about your risks provides an opportunity to modify or control risks better long-term to reduce your chances of having a stroke.

How to tell if someone could be having a stroke

Remember the B.E.F.A.S.T. acronym:

  • You notice they are suddenly acting or walking as if drunk or dizzy, but they have not had anything to drink
  • You ask them to smile, and their face is asymmetrical
  • Their speech is slurred or they are unable to find the right words, or they seem confused and have trouble understanding you
  • They have difficulty maintaining or are unable to lift their arms or legs
  • They have double or blurred vision

If you notice any of the above, call 911 immediately.

How will having a stroke affect me?

Many individuals recover well after a stroke, and enjoy a good quality of life. The challenge is that certain types of stroke have the potential of causing significant neurological impairment, which highlights the need for prompt identification of stroke symptoms and treatment. If you think having a stroke is inevitable, you are wrong—there are many things you can do to reduce the chance of it happening. However, it starts with partnering with your primary care physician to discuss your particular risk factors and determine what you can do to modify your risks—not just today, but long-term—to reduce your risk of stroke and maintain good brain health.

Have you or someone you love experienced a stroke? Learn about Mount Sinai’s services and therapies that can help

For 24th Year, Mount Sinai Receives Top Safety Rating for Cardiac Catheterization

Updated on Apr 14, 2023 | Cardiology, Featured

Annapoorna S. Kini, MD, left, and Samin K. Sharma, MD.

For the 24th consecutive year, The Mount Sinai Hospital’s Cardiac Catheterization Laboratory or its interventionalists have received the highest two-star safety rating from the New York State Department of Health (NYSDOH) for percutaneous coronary interventions (PCI), also known as angioplasty. PCI—one of the most common procedures for patients with coronary artery disease—opens blocked arteries and restores normal blood flow to the heart.

In a highlight of the report, Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, received the two-star rating for significantly lower 30-day risk adjusted mortality for PCI in all cases and in non-emergency cases. She was the only interventionalist in the state to receive this rating in both categories, while performing 2,844 procedures in the latest period reported, December 1, 2016, to November 30, 2019.

“This NYSDOH report is again a testament to the top quality work being done in The Mount Sinai Hospital Cardiac Catheterization Laboratory by the dedicated interventionalists, making it No. 1 in the nation in volume and quality,” says Samin K. Sharma, MD, Director of the Mount Sinai Cardiovascular Clinical Institute, and Senior Vice President of Operations and Quality for Mount Sinai Heart.

Mount Sinai’s exceptional ratings appeared in the latest NYSDOH report, released in April 2023, on the risk factors associated with PCI at 65 hospitals across New York State. The NYSDOH began publishing PCI safety ratings in 1995, in reports designed to help patients make better decisions about their care based upon a statistical review of each hospital’s data.

“Despite taking on some of the most challenging referrals, our Cath Lab has received the double-star rating again. I believe that our efforts as educators and investigators—in our conferences, live cases, publications, educational applications, and clinical trials—bring us to the forefront of the field,” says Dr. Kini, the Zena and Michael A. Wiener Professor of Medicine.  “We are looking forward, toward the horizon, and are always seeking the best practices and proven methods to provide our patients with the best outcomes.”

During the three-year period, The Mount Sinai Hospital had a risk-adjusted PCI mortality rate of 0.85 percent for all of its cases—emergency and nonemergency—significantly lower than the statewide average of 1.22 percent, while performing the largest number of procedures (10,347). For nonemergency cases, Mount Sinai’s PCI mortality rate was 0.50 percent, compared with the statewide average of 0.79 percent

 

Read more about The Mount Sinai Hospital’s Cardiac Catheterization Laboratory

Yellow III Trial Finds That Lipid Lowering With a PCSK9 Inhibitor Could Benefit Heart Patients on Statin Therapy

Updated on Apr 7, 2023 | Cardiology, Featured, Research

Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, was principal investigator of the late-breaking clinical trial.

Even after high-intensity statin therapy, a considerable residual risk exists for heart attack and stroke among adults with coronary artery disease (CAD). A clinical study led by Mount Sinai offers strong evidence that aggressive lipid lowering with a proprotein convertase subtilisin kexin type 9 inhibitor (PCSK9i), along with a statin, can significantly reduce that threat and potentially help doctors identify patients who would benefit most from intensification of treatment to change their coronary plaque morphology and composition.

The findings were presented by principal investigator Annapoorna S. Kini, MD, Director of the Cardiac Catheterization Laboratory at The Mount Sinai Hospital, as a late-breaking clinical trial at the American College of Cardiology/World Congress of Cardiology meeting in New Orleans in March.

The study, known as Yellow III, used advanced multimodality imaging to show favorable plaque characteristics after a 26-week regimen of evolocumab, including substantial reductions in total cholesterol, LDL cholesterol, and total/HDL cholesterol ratios. More specifically, the investigation showed a significant increase in the minimum fibrous cap thickness (FCT) through optical coherence tomography (OCT), reduction in lipid core burden index at the maximal 4-mm segment (maxLCBI4mm) through near-infrared spectroscopy, and reduction in atheroma volume through intravascular ultrasound in angiographically nonobstructive lesions.

“By using all three modalities for the first time in a study of this type we were able to demonstrate a measurable improvement in fibrous cap thickness, as well as in plaque volume,” says Dr. Kini, Zena and Michael A. Wiener Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai. “In addition, blood samples were drawn to enable us to conduct a gene expression analysis of peripheral blood mononuclear cells. This will help us uncover through ongoing research the molecular mechanisms responsible for beneficial changes in atherosclerotic lesions of patients treated with evolocumab.”

The investigation showed a significant increase in the minimum fibrous cap thickness through optical coherence tomography (OCT) imaging. Thicker fibrous caps are associated with more stable plaques that are less prone to rupture and subsequent adverse cardiac events.

Prior studies have established the ability of PCSK9 inhibitors—injectables that block PCSK9 proteins from breaking down LDL receptors—to reduce residual cardiovascular risk in statin-treated patients. As a result, the 2018 American College of Cardiology/American Heart Association cholesterol guidelines recommended the use of PCSK9 inhibitors in patients with stable CAD if sufficient LDL-lowering was not achieved on maximally tolerated doses of statins. In the Yellow III trial, 137 patients scheduled for elective coronary angiography were prescribed maximum-dosage statin therapy for at least four weeks before undergoing multimodality intracoronary imaging. They were then given evolocumab (140 mg) every two weeks for 26 weeks and reimaged to assess changes in plaque morphology and composition.

The gene expression analysis of peripheral blood mononuclear cells was a particularly important part of the Yellow III study because it could potentially lead to the development of biomarkers able to predict which patients would benefit the most from different approaches to lipid lowering. Researchers found that fibrous cap thickness did not improve in 20 percent of patients. The hope is that a genotypic characterization of patient response will ultimately reveal which patients should remain on statins, which should be put on a PCSK9 inhibitor, and which might benefit from combination therapy.

“We believe studies like ours can help physicians personalize therapies for their patients with coronary artery disease,” says Dr. Kini, a renowned interventionalist. “The first step could well be a recommendation for lifestyle modification, like exercise and diet. But it is important for cardiologists to know who could also benefit from the addition of a high-intensity PCSK9 inhibitor, particularly in the case of statin-treated patients with multiple risk factors.”

 

 

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