People often use “heart rate” and “pulse rate” interchangeably, but medically they are distinct measurements with different methods and implications. Understanding both helps in evaluating cardiovascular health more accurately.
Heart rate (HR) refers to how many times the heart beats per minute. [1]It is often measured using an Electrocardiogram (ECG), which detects the electrical signals of the heart.
A normal resting HR for most adults ranges from about 60 to 100 beats per minute (bpm) when sitting or lying down and feeling relaxed. Various factors affect heart rate, including physical fitness, emotional state, medications, body temperature, health conditions such as thyroid dysfunction, and more. A heart rate less than 60 beats per minute is bradycardia and more than 100 bpm is tachycardia.
Pulse rate (also called pulse) is the number of times the arteries expand and contract with each heartbeat. It is felt (palpated) at peripheral sites like the wrist (radial artery), neck (carotid artery), or even the foot. This expansion is due to the blood being pushed into arteries when the heart contracts. [1]
While pulse normally matches heart rate, differences can occur. For example, in cases of arrhythmia, some heartbeats may not produce a strong enough pulse wave to be felt peripherally, so the pulse rate may be lower than the heart rate. Conditions such as weak circulation, vascular disease, or arterial obstruction can cause this discrepancy. [1]
Heart rate is best measured by ECG or heart monitors that detect the electrical activity of the heart. These devices record each contraction regardless of whether the pulse is strong or weak.
Pulse rate is measured by physically feeling the pulse at an artery and counting the beats per minute.
Pulse can also be measured by Photoplethysmography (PPG) sensors in wearable devices (which use light to detect blood flow changes in peripheral tissue).
The topic was well explained by Theja V, a Biomedical Engineering graduate in an ongoing discussion in MedBound Hub. She also asked the participants whether they have ever compared their manual pulse count with their smartwatch or oximeter readings; and whether it was the same or different.
Why This Matters Clinically
Differences between heart rate and pulse rate, called a pulse deficit, can indicate conditions like atrial fibrillation or other arrhythmias. Clinicians rely on ECG to confirm these discrepancies, as pulse alone may not reveal all abnormal beats. Accurate measurement of HR and PR is crucial for diagnosing heart rhythm disorders, guiding treatment, and monitoring heart health.
For accurate diagnosis of heart conditions, medical practitioners rely on electrical measurements (ECG), while pulse can be a useful, accessible proxy in many non-clinical settings.
When to See a Doctor
If your heart rate and pulse rate don’t match or you notice irregular rhythms, dizziness, or shortness of breath, consult a healthcare professional promptly. Early detection of arrhythmias can prevent complications.
Heart rate measures the internal electrical beats of the heart.
Pulse rate measures the mechanical effect—how many times you feel the arteries pulsing.
They often match in healthy people at rest. Differences can arise in certain health conditions or when measured by different methods.
For accurate diagnosis of heart conditions, medical practitioners rely on electrical measurements (ECG), while pulse can be a useful, accessible proxy in many non-clinical settings.
Reference
American Heart Association. “All About Heart Rate (Pulse).” American Heart Association. Last reviewed May 13, 2024. https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/all-about-heart-rate-pulse.
National Institutes of Health. “Arrhythmias: Causes, Symptoms, and Diagnosis.” https://www.nhlbi.nih.gov/health-topics/arrhythmia
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