Big heart rate. The main functional indicators of the work of the heart

Heart rate (HR), or pulse, is the number of times the heart beats per minute and is a measure of how hard the heart is working to pump blood around the body. Resting heart rate refers to the lowest number of beats during those moments when the body is in a state of almost absolute rest. Knowing your resting heart rate can help you assess your overall health, as well as determine normal heart rate readings. Reducing this number can significantly reduce the risk of heart attack or stroke.

Steps

Heart rate measurement

Find out your resting heart rate. Before taking measures to lower the heart rate, it is important to know its current value. To do this, you need to measure the pulse on the carotid artery (on the neck) or on the wrist.

Measure your pulse. To measure the carotid pulse, place your index and middle fingers on the neck on one side of the trachea. Gently press down to feel the pulse. For the most accurate result, count the number of beats in 60 seconds.

You can count the pulse for 10 seconds and multiply by 6 or for 15 seconds and multiply by 4.
To measure your wrist pulse, place one hand palm up.
With the index, middle and ring fingers of the other hand, press the area below the base of the thumb - you should feel the pulse.
If you have a stethoscope, you can use it. Lift or take off your shirt, insert the stethoscope into your ears, put it against your chest, and chance. Count the beats of your heart in a minute.

Assess resting heart rate. After you have measured the pulse, you need to know what its normal value should be. At rest, heart rates between 60 and 100 are normal. Values above 90 are considered high.

Know when to see a doctor. High resting heart rates are not an immediate threat to life, but in the long run they can lead to health problems. In such cases, it is recommended to gradually reduce the heart rate with exercise. It is necessary to consult a doctor in case of a very rare pulse or cases of unexplained acceleration of heart rate, especially accompanied by dizziness.

Do not smoke. Smoking is known to destroy the body, and among other negative effects is the fact that smokers have a higher resting heart rate than non-smokers. Reduce the number of cigarettes you smoke per day, or better yet, stop smoking altogether to lower your heart rate and improve your health.
- Nicotine constricts blood vessels and adversely affects the condition of the heart muscle and blood vessels. Quitting smoking can improve blood pressure, greatly improve circulation and overall health, and reduce the risk of cancer and breathing problems.
Reduce your caffeine intake. Caffeine and caffeinated foods such as tea and coffee are known to increase heart rate. Reduce your caffeine intake to lower your heart rate.

Don't drink alcohol. Drinking alcohol leads to an increase in heart rate, so avoiding it can help lower it.
Reduce stress. Reducing the stress levels in your life isn't easy, but over time it can help lower your heart rate. Severe stress negatively affects health. Try relaxation techniques such as meditation or tai chi. Try to devote some time to relaxation and deep breathing every day.
- Everyone is different, so find a way to relax that works for you.
- Soothing music or taking a long bath may help.

Certain medications, as well as caffeine and nicotine, can increase your heart rate. Your doctor can better balance the benefits of a drug with its side effects.
Talk to your doctor about your general health. Resting heart rate is only one measure of heart health. Your doctor may recommend that you undergo additional tests.

During physical exertion, the functional indicators of the work of the heart change. The heart rate increases, the stroke volume of the heart increases, blood flow parameters change, the respiratory rate increases, changes occur in other organs. It is very important that the indicators of the work of the heart do not go beyond the limiting norms, especially for people with diseases of the cardiovascular system.

Normal heart rate (HR) per minute in adults

The main indicators of heart function in adults are as follows:

the normal heart rate at rest is 65 beats / min: for trained people - 50 - 60 beats / min, for untrained people - 70-80 beats / min;
heart rate decreases with age;
heart rate per minute in women is 5-6 beats higher than in men;
Heart rate increases by 10% when you sit down and by 20% when standing;
during sleep, heart rate decreases by 5-7 beats / min;
after eating, especially protein, within 3 hours, the heart rate increases by 3-5 beats / min;

The heart rate in adults increases in proportion to the ambient temperature (with an increase in body temperature by 10 C, the heart rate increases by 10 bpm) and the intensity of physical activity.

Norms of stroke and minute volume of the heart

In a physically active person, compared with a "couch potato", with a heart rate difference of 20 beats / min, the heart beats 30,000 beats less often in 1 hour, and more than 1,300,000 beats in one year.

At rest (during diastole, relaxation), the volume of blood in the ventricle consists of three components:

systolic (shock) volume ejected during heart contraction;
a reserve volume that increases the shock with an increase in the contractile function of the myocardium (for example, during exercise);
residual volume that is not ejected from the ventricle even with the maximum contraction of the myocardium.

With an increase in physical activity, the rate of stroke volume of the heart increases due to the reserve volume. When the reserve volume of blood is exhausted, the increase in stroke volume will stop, and at very high loads it will even decrease, since there will be no effective filling of the heart.

A detrained heart works uneconomically and responds to any load mainly with an increase in heart rate, and not with an increase in stroke output. Regular physical activity gradually increases the power of the heart, which, contracting relatively less often, but stronger, is able to provide normal blood supply to all the muscles included in the load.

The heart of an untrained person at rest ejects 50-70 ml of blood into the aorta in one contraction. Regular exercise improves heart function and increases stroke volume to 90-110 ml at rest.

Minute volume of the heart is determined by stroke volume and heart rate. During physical activity, MOS increases due to the fact that with active muscle contraction, vein compression occurs, blood outflow from all organs increases, and the heart fills with blood faster. MOS at the beginning of work gradually increases due to stroke volume and an adequate increase in heart rate, and when a certain power is reached, it becomes stable.

Types of blood flow and its norms: speed and indicators of blood flow

In order to create favorable conditions for metabolic processes during physical exertion, in addition to increasing the cardiac output, redistribution of blood flow in organs and tissues is required. There are several types of blood flow, among them muscular, coronary, cerebral and pulmonary.

Blood flow in the muscles. With physical activity, the heart rate, the volume of blood that is pushed out of the heart into the vessels, and blood pressure increase. All this is necessary so that more oxygen enters the working muscles, which are penetrated by thin blood vessels (capillaries). Some of them are working, while others are sleeping. During physical work, the capillaries “wake up” and are also included in the work. As a result, the surface through which oxygen is exchanged between blood and tissue increases. This is what experts consider the main factor that ensures the high performance of the heart.

The proportion of blood flow in the muscles in relation to the total blood flow in the body increases from 20% at rest to 80% at maximum loads.

Coronary blood flow:

Supplies blood to the heart muscle through the right and left coronary arteries;
indicators of coronary blood flow at rest - 60-70 ml / min per 100 g of myocardium;
under load increases by more than 5 times;
the rate of coronary blood flow is regulated by metabolic processes in the myocardium and the pressure in the aorta.

Pulmonary blood flow:

the rate of pulmonary blood flow is determined by the position of the body. At rest: lying down - 15% of the total blood volume, standing up - 20% less than lying down;
cardiopulmonary blood flow increases during exercise and is redistributed due to an increase in the pulmonary component (from 600 ml to 1400 ml) and a decrease in the cardiac one;
during intense physical exertion, the cross-sectional area of the pulmonary capillaries increases by 2-3 times and the rate of blood passing through the lungs increases by 2-2.5 times.

Blood flow in the internal organs. At rest, blood circulation in the internal organs is 50% of the cardiac output. With an increase in physical activity, it decreases and at its peak is only 3-4%. This ensures optimal blood supply to the working muscles, heart and lungs.

The proportion of blood flow in the internal organs decreases from 50% at rest to 3-4% at maximum loads.

Features of the respiratory rate during physical exertion

The depth and frequency of breathing during physical exertion increases due to the intensity of contractions of the respiratory muscles: diaphragm and intercostals. The more they are trained, the more efficient is the ventilation of the lungs, which increases with increasing load and oxygen demand. At maximum loads, it can increase by 20–25 times compared to the state of rest due to an increase in the frequency (up to 60–70 per minute) and volume (from 15 to 50% of the vital capacity of the lungs) of breathing. In trained people, vital capacity, circulating air volume, maximum ventilation increase, and resting respiratory rate decreases. The peculiarity of breathing during physical exertion is that regular training can increase the maximum oxygen consumption by 15 - 30%.

After inhalation, oxygen, passing through the upper respiratory tract and lungs, enters the blood. A small proportion of oxygen dissolves in the blood plasma, most of it binds to a special protein - hemoglobin, which is contained in red blood cells. It is he who carries oxygen to the working muscles.

Oxygen consumption increases with the intensity of the load. However, there comes a point when breathing during exercise is no longer accompanied by an increase in oxygen consumption. This level is called maximum oxygen uptake.

Carbon dioxide, which we release when we exhale, is the most important regulator of the function of internal organs. Its deficiency leads to spasms of the bronchi, blood vessels, intestines and may be one of the causes of angina pectoris, arterial hypertension, bronchial asthma, stomach ulcers, colitis. In order to avoid a deficiency of carbon dioxide in the body, it is not recommended to breathe very deeply. “Shallow” breathing is considered useful, in which the desire to breathe deeper remains.

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You most likely know your blood pressure readings. But do you know what your resting heart rate is? What should be the norm, and when should you be on your guard? If the increase in heart rate at rest is present for a long time, this indicates too frequent heart contractions. A prolonged increase in heart rate at rest leads to damage to the heart. Many studies show that a lower heart rate is associated with longevity, and that a higher resting heart rate is associated with a shorter lifespan. The slower a person's heart rate at rest, the better for their health. Slow heart rate per minute at rest is one of the indicators of physical fitness. almost 2 times slower than the heart of people who are not related to sports. So, what should be the normal pulse of a healthy person? What does the acceleration of the dynamics of the heartbeat indicate?

Normal resting heart rate

A pulse of 60 beats per minute is ideal. Previously, a heart rate of 70 beats per minute to 80 was considered healthy. According to new research results, the ideal values of the resting pulse (heart rate) have been changed to a heart rate of 60. Large epidemiological studies have confirmed that a longer lifespan is associated with a lower heart rate for 1 min in a state of calm. Working at low speeds provides the heart with wear resistance and durability.

Studies have also shown the negative effect of increased heart rate, i.e., the constant faster work of the heart muscle. People with a heart rate of 75 beats per minute or more (77 and above) have a 3 times increased risk of cardiovascular disease.

Norm in men and women

The normal pulse of an adult, in the supine position, measured immediately after waking up, is 61-72 beats / min. in men, and 67–76 beats / min. among women. The norm in women is higher due to the physiologically caused more frequent heart rate.

The actual number of heart beats in an adult at rest is measured during daily activities. It increases slightly, but should not exceed (at rest). When moving, you can observe an increase in rhythm - a healthy person can have a pulse of 85 beats per minute.

Indicators in a child

Heart rate in children is individual, varies, depends on many factors. Reasons for a high heart rate (as well as a low one) include physical activity or lack thereof, general health, environmental exposure, and the child's current mood.

Children usually have a higher resting heart rate than adults. The heart of a newborn beats 160 times/min., 12-year-old children usually have a pulse of 90-100 beats/min. The indicators for girls and boys do not differ. The pulse in a calm state reaches adult values after 15 years.

Usual values:

Age, years	Average number of contractions per minute
newborns	140
1	130
2	120
4	110
6	105
8	100
10	90
12	80
15	75

Normal performance in athletes

The main goal of an athlete's training is to increase physical performance. Planning and comprehensive training management is a creative process that determines the direction and pace of development from beginner to professional.

When monitoring training, measurable biological variables are important, which include resting heart rate.

The indicator of how much the calm value of the heart rate should be is an indicator of the state of fitness. During endurance exercise, there is an increase in the heart and activation of the parasympathetic system, which leads to a decrease in heart contractions. Almost all professional athletes have his performance less than 50 beats per minute (most often, less than 45 beats per minute; the lowest value was recorded by M. Indurain - 28 beats per minute).

A pulsating heart rate is measured with a heart rate monitor or by palpation of the large arteries in the morning, after waking up, in the supine position. Normal fluctuations are 4-6 beats / min. If fluctuations exceed 8 beats / min., It is necessary to look for the reason why they increase. The main factors include illness or overtraining (in which case training should be interrupted until the condition stabilizes).

General characteristics of heart rate

Heartbeat can be felt on the neck, wrists, in the groin area. It is transmitted through large arteries to every organ. If an artery passes under the surface of the skin, a pulsation can be felt. The heartbeat, reflected by the pulse in a person, is caused by the contraction of the left ventricle, is an indicator of the heart rhythm.

The contractions of the heart respond sensitively to the needs of the body. The main reason why the pulse quickens is represented by physical stress, because at this time the body has a great need for oxygen supply. Nerve impulses also affect its speed. Therefore, the pulse rises in a state of stress, fear, in anticipation of something unpleasant.

Important! Under the influence of these factors, a pulse of 70 in a couple of minutes can rise to a value of even 180 beats per minute at rest!

Heart rate develops from birth. The hearts of newborns beat at a speed of 140-180 beats / min. Increased is associated with higher requirements of the developing organism. The heart muscle is not yet sufficiently prepared for pumping. Indicators gradually decrease, and values characteristic of an adult are measured during puberty.

The rate of heart rate in an untrained person

Heart rate is the speed at which the heart contracts. It is expressed in beats per minute. In a calm state, the standards are defined as 60-90 beats / min., But for professional athletes, the figure is usually half that. Factors that determine why the frequency of contractions jumps are represented by increased tension, increased physical activity, stress.

Too high a heart rate (up to 200 beats per minute) can be a symptom of heart disease, but it also has other causes. Often the cause of the disorder is the use of hormonal contraception, poor lifestyle, obesity. This condition is accompanied by a number of manifestations: it is difficult for a person to breathe, he suffers from excessive sweating. In such cases, it is important to see a doctor.

Important! In people who are far from sports, the heart functions less economically, it contracts faster. The frequency of contractions increases dramatically even after a small load on the body.

If you are not an active athlete and have a too low heart rate (up to 55 beats per minute), which accompanies breathing difficulties, severe fatigue, this may indicate a serious problem that requires a visit to a doctor who will advise what to do to stabilize the condition. Small deviations are corrected without medication. A very low rate of contractions is solved by the use of a pacemaker.

In a dream

Heart rate at rest reaches its lowest values during sleep, the indicators are individual. In sleep, the body enters a calming phase, so the heart behaves similarly - the heart rate drops by 10-20%. After waking up and getting out of bed, the heart rate returns to normal.

Heart rate according to age

The resting heart rate of an untrained adult varies to some extent by age—it differs between a young adult and an older person. The normal pulse of a person over the years is divided into 3 groups:

<35 лет;
35–50 years;
>50 years.

Up to 35 years old

The resting heart rate in a person younger than 35 years of age is 60-90 beats / min. A pulse of 90 and above is a sign of a violation of cardiac activity, requiring a visit to a specialist.

Average age

At the age of 50 years, the average heart rate at rest should be approximately 70 beats / min. As in the case above, a high resting heart rate is the reason for consulting a specialist.

Elderly age

In the elderly, the number of heart beats slightly increases, the resting pulse is:

50-60 years - 75 beats / min.;
60–80 years old - 80 beats / min.

Important! A significant change in the contractions of the heart in an adult at rest may indicate the possible development of the disease!

pivot table

The table shows the average indicators for 4 age groups:

What do abnormalities in cardiac activity indicate?

A violation of its rhythm (cardiac arrhythmia) is associated with the number of heart contractions. Physiologically, a low heart rate is common in athletes and indicates a stronger heart capable of pumping more blood (vagotonia).

Arrhythmia

Cardiac arrhythmia is a heart rhythm disorder that causes a violation of its activity. For example, in a calm state, the heart beats like when running. Arrhythmia symptoms:

cardiopalmus;
feeling of cardiac arrest;
irregular chaotic pulse;
chest pain;
weakness;
fatigue;
disturbance of consciousness;
lack of breath.

You can calm the pulse during arrhythmia with the help of special medications that the doctor will prescribe.

Bradycardia

The next disorder characterized by low heart rate is bradycardia, in which the actual heart rate slows down to less than 60 bpm. in men and less than 65 beats / min. among women. This disorder can be caused by a heart attack, intracranial damage, or certain medications.

Tachycardia

The opposite of this disorder is tachycardia, in which the number of heart contractions increases, amounting to more than 100 beats / min. in men and 110 beats / min. Among women. This condition most often occurs during physical overstrain, in stressful situations. However, tachycardia can also indicate the presence of febrile illness, anemia, heart failure, intoxication, and thyroid disorders. In such cases, in deciding how to calm the pulse, the elimination of the primary disorder or disease plays an important role.

Heart rate monitoring is recommended for all people who care about their health. Pulse monitoring is a good prevention of many diseases. It will help a person understand his body, and in case of any inconsistencies, will be the first signal to see a doctor.

Pulse measurement allows you to evaluate the functioning of the cardiovascular system and draw preliminary conclusions about possible violations.

Heart rate is an important criterion in the diagnosis of various diseases, in particular arrhythmias.

In order to correctly measure pulse fluctuations, it is necessary to know the technique of the procedure and be able to adequately evaluate the results obtained. The pulse rate by age is significantly different, since even gender affects the rate of heart contractions. Let us consider in more detail on what factors the pulse value depends and what readings of this criterion are normal.

Acceleration of heart contractions

Rhythmic oscillations of the walls of blood vessels, provoked by contractions of the heart muscle, are called the pulse.ohm.

It can accelerate or slow down depending on the presence of physiological and external factors of influence. Increased heart rate, as a rule, is caused by such reasons:

strong emotional excitement;
physical fatigue;
significant stress on the body;
consumption of alcoholic beverages and coffee.

There are also other factors against which the pulse can be accelerated. These include: time of day, increased body and air temperature, food intake. Age and gender play a role. It has been proven that in women, the pulse rate is slightly higher than in men, by about 7-8 beats. The indicators can be influenced by the functional state of the body, various diseases and organic lesions. The speed of pulse fluctuations even depends on growth - the higher the person, the slower his heart contractions occur.

It is noted that the slowdown of the pulse in people is observed at night, and the natural acceleration is typical for the second half of the day. A feature of this criterion of the work of the heart is that the same pulse rates indicate different conditions. For example, for a newborn, a heartbeat of 140 beats per minute is considered normal, but for an adult, this is an overly accelerated pulse, indicating a violation of the heart. It is also worth noting that the pulse rate in the elderly is higher than in young and middle-aged people.

Heart rate by age

In order to accurately characterize the permissible norms and possible deviations of pulse fluctuations for people of different ages, we will use the table.

Person's age	Minimum allowable heart rate	Maximum allowable heart rate	Average heart rate
Neonatal period (from 0 to 1 month)	110	170	140
From 1 to 12 months.	102	162	132
1 to 2 years	94	154	124
4 to 6 years old	86	126	106
6 to 8 years old	78	118	98
8 to 10 years	68	108	88
10 to 12 years old	60	100	80
12 to 15 years old	55	95	75
15 to 50 years old	60	80	70
50 to 60 years old	64	84	74
60 to 80 years old	69	89	79

Using such a table, you can correctly evaluate the results of measurements of pulse fluctuations. But, in addition to the fact that everyone should know the normal value of the pulse for their age, one should understand what a slow or accelerated heartbeat indicates.

If the pulse rate exceeds the maximum allowable value, then this should be a reason to seek medical help.

Increased heart rate may be due to functional factors. For example, a pulse of up to 90 beats per minute and above is observed in women with the onset of menopause and indicates an attack tachycardia. A decrease in the level of the hormone estrogen in the blood, caused by other reasons, also leads to an acceleration of the heartbeat.

How to distinguish functional changes in the pulse from pathological? In the first case, people have no complaints about symptoms such as:

dizziness;
chest pain;
visual impairment;
dyspnea;
pre-fainting state.

If the listed signs are present, then the increase in pulse fluctuations is associated with pathological causes.

Diseases that can provoke tachycardia (increased heart rate):

congenital heart defects, organ pathologies;
diseases of the endocrine system;
CNS lesions;
tumor formations;
some infectious diseases.

Regardless of what reasons provoked an acceleration of the heartbeat, you need to seek medical help in cases where the maximum heart rate by age is exceeded.

The maximum permissible value without a table can be calculated by the formula: subtract the number of full years of a person from 220.

Both an increase and a decrease in the speed of contractions of the heart muscle can be of a functional or pathological nature. Slow heart rate to 60 beats per minute or less is a symptom bradycardia .

Diseases in which there is a slowdown in the pulse:

myocardial infarction;
intoxication of the body;
increased intracranial pressure;
hypothyroidism;
organic lesions of the heart;
ulcer pathology;
inflammation of the tissues of the heart muscle.

Bradycardia can also be a consequence of taking certain types of medications.

It is important to regularly measure and monitor the indicators of pulse fluctuations, and in case of abnormalities, contact a cardiologist!

Resting pulse is an indicator of overall health. Everyone should know their normal resting pulse and periodically count it, since the slightest deviation in rhythm or frequency signals illness or pathology. For the accuracy of the result, it is important to know the rules for measuring heart rate.

How to measure your heart rate

Heart rate can be measured on the carotid artery, and at the temples, and under the knee, and at the bend of the elbow, but the wrist remains the most popular measurement site.
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Most people, even those far from medicine, are familiar with the basic concepts of the rules for measuring the pulse, but still make mistakes in measurements. It is better to measure the pulse using 3 fingers: ring, middle and index on the radial or radial artery, which is located slightly below the thumb. When measured correctly, each finger feels a beating in the artery. There is no cause for concern if the heart rate on the left and right hand is different, this is a normal physiological feature of the body. In order for the indicators to be true, it is worth paying attention to the following factors:

At different times of the day, the heart rate is different, so you need to constantly record the indicators at the same time of the day. Measurement of the pulse at rest should be done in the morning, after waking up, lying in bed - this is the best way recognized by doctors.
It is impossible to detect the number of beats for 15 seconds and then multiply by 4, since irregularities in the rhythm, for example, tachycardia or bradycardia, will not be detected.
It is worth refraining from measurements after eating, physical exertion, taking alcohol and drugs, after a bath or bad sleep.

Heart rate at rest

The normal heart rate for an adult at rest ranges from 60 to 90 beats per minute, but this is an average value. Pulse rates differ in men and women and depend on age. Under the influence of emotions or physical activity, the heart rate rises, sometimes even up to 200 beats per minute, and this is considered the norm.

The norm in women and men

The pulse rate for women and men is different.

Since men are the stronger sex and endure negative life events and emotions more steadfastly, their pulse rates are always lower than those of women who are initially prone to strong feelings. Although, in a theoretical point of view, the resting heart rate for men and women is almost the same, in life the difference is 7-8 units. But these are only guesses, because there is no scientific explanation for this phenomenon.

With age, the heart rate tends to increase. In a state of death throes, a person's heart rate sometimes increases to 160 beats per minute. If the deviation from the norm is permanent, then we are talking about the presence of rhythm disturbances: arrhythmias or bradycardia, which require consultation with a cardiologist. For the most part, arrhythmias do not cause significant harm to the human body and serious treatment is not required.

Norm for children

The heart rate of a child is directly related to age.

At birth, a baby's heart rate is twice that of an adult with an average of 140-150 beats per minute. Gradually, as they grow older, every 3-4 years, the heart rate decreases by 10-15 and by the age of 20 they reach 60-80 beats per minute - the norm for adults. Therefore, if a small child has a heart rate of 100 beats per minute, this is not a pathology, but the normal functioning of the heart.

Norm for an athlete

The word "athlete" should be understood as people who are professionally involved in sports, amateurs who do it for themselves and for the sake of the beauty of their bodies, and people whose work is associated with intense physical activity. In a person involved in sports, the normal pulse at rest is from 30 to 50 beats / min. Such low rates do not harm the athlete and the person feels absolutely normal. The difference in heart rate in an adult untrained person at rest and the heart rate of an athlete is only in a large gap in indicators. For an ordinary person, a heart rate of 40-50 beats per minute is a sign of bradycardia, and for an athlete it is quite a good indicator.

Changes in heart rate with age

The change in the frequency of contractions in childhood is associated with the growth of the body and, in particular, with the growth of the heart, which grows and is able to pump more blood in one beat. After 40-50 years, the heart rate changes due to the aging of all body systems. The heart ages and its ability to perform its main functions deteriorates:

the elasticity of blood vessels decreases;
the ability of heart tissues to contract and the volume of blood ejected by them decreases;
increases the sensitivity of the heart to hormones that affect the increase in pressure and heart rate.

Why do heart rate changes occur?

Stress affects the psychological state of a person, thereby increasing the pulse.

The change in the heart rate is influenced by a number of factors not related to the body. Temporary tachycardia occurs due to severe mental and emotional overexcitation, stress. An increase in heart rate in a healthy person during physical activity is an adaptation of the body to a change in regimen. Changes in the temperature regime also affect the heart rate, this is especially reflected in weather-dependent people. Provoke a sharp increase in heart rate is capable of food or drinks: coffee or strong tea. In sleep, the heart rate, on the contrary, slows down. In addition to external causes, a change in heart rate occurs due to pathological processes within the body. For this reason, doctors distinguish between the concepts of high and low heart rate.