{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T10:13:03Z","timestamp":1766139183788,"version":"3.41.2"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Clinical Hypertension"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long\u2010term outcomes in hypertensive patients. This study examines the association between visit\u2010to\u2010visit variability in BP and heart rate (HR) and its effect on adherence to beta\u2010blocker therapy among outpatients. Conducted across 160 hospitals in China from January 1, 2011, to December 31, 2011, this study included 9225 hypertensive outpatients prescribed metoprolol succinate. BP and HR variability were assessed over three visits (baseline, 1\u2010month, and 2\u2010month follow\u2010up) using standard deviation (SD) and mean\u2010independent parameters. Nonadherence was defined as medication discontinuation or treatment regimen changes by the 2\u2010month follow\u2010up. Among the 9037 patients analyzed, the mean age was 58.85 years (\u00b112.54), and 52.9% were male. Visit\u2010to\u2010visit variability in the rate\u2013pressure product (RPP; SBP\u00d7HR) was a significant predictor of nonadherence, with an odds ratio (OR) of 1.26 (95% confidence interval [CI]: 1.04\u20131.53, <jats:italic>p<\/jats:italic> &lt; 0.05) for the top\u2010decile SD of RPP, independent of mean RPP. Variability in diastolic blood pressure (DBP) and pulse pressure (PP) were also associated with nonadherence, with ORs of 1.65 (95% CI: 1.35\u20132.00, <jats:italic>p<\/jats:italic> &lt; 0.001) for DBP and 1.66 (95% CI: 1.39\u20131.99, <jats:italic>p<\/jats:italic> &lt; 0.001) for PP, independent of their mean values. Patients with fluctuations in PP or HR had a higher risk of nonadherence compared to those with consistent reductions in these measures. Visit\u2010to\u2010visit variability in RPP, DBP, and PP is a significant predictor of nonadherence to beta\u2010blockers, regardless of mean levels. Addressing this variability is critical for improving adherence to antihypertensive treatments and optimizing patient outcomes.<\/jats:p>","DOI":"10.1111\/jch.70065","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T15:35:15Z","timestamp":1746804915000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Variability in Blood Pressure and Heart Rate on Beta\u2010Blocker Adherence"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1032-2292","authenticated-orcid":false,"given":"Yan","family":"Li","sequence":"first","affiliation":[{"name":"Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jia\u2010Yin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital, Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qian\u2010Yun","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital, Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong\u2010Ya","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital, Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"De\u2010An","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital, Capital Medical University  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi\u2010Ming","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital, Capital Medical University  Beijing 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