Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence
ABSTRACT Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long‐term outcomes in hypertensive patients. This study examines the association between visit‐to‐visit variability in BP and heart rate (HR) and its effect on adherence to beta‐blocker thera...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | The Journal of Clinical Hypertension |
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| Online Access: | https://doi.org/10.1111/jch.70065 |
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| author | Yan Li Jia‐Yin Sun Qian‐Yun Guo Hong‐Ya Han De‐An Jia Zhi‐Ming Zhou Zhi‐Jian Wang Ying‐Xin Zhao Yu‐Jie Zhou Shi‐Wei Yang |
| author_facet | Yan Li Jia‐Yin Sun Qian‐Yun Guo Hong‐Ya Han De‐An Jia Zhi‐Ming Zhou Zhi‐Jian Wang Ying‐Xin Zhao Yu‐Jie Zhou Shi‐Wei Yang |
| author_sort | Yan Li |
| collection | DOAJ |
| description | ABSTRACT Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long‐term outcomes in hypertensive patients. This study examines the association between visit‐to‐visit variability in BP and heart rate (HR) and its effect on adherence to beta‐blocker 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‐month, and 2‐month follow‐up) using standard deviation (SD) and mean‐independent parameters. Nonadherence was defined as medication discontinuation or treatment regimen changes by the 2‐month follow‐up. Among the 9037 patients analyzed, the mean age was 58.85 years (±12.54), and 52.9% were male. Visit‐to‐visit variability in the rate–pressure product (RPP; SBP×HR) was a significant predictor of nonadherence, with an odds ratio (OR) of 1.26 (95% confidence interval [CI]: 1.04–1.53, p < 0.05) for the top‐decile 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: 1.35–2.00, p < 0.001) for DBP and 1.66 (95% CI: 1.39–1.99, p < 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‐to‐visit variability in RPP, DBP, and PP is a significant predictor of nonadherence to beta‐blockers, regardless of mean levels. Addressing this variability is critical for improving adherence to antihypertensive treatments and optimizing patient outcomes. |
| format | Article |
| id | doaj-art-cfa26ae3e0be42cdbd56c94f45ef6063 |
| institution | OA Journals |
| issn | 1524-6175 1751-7176 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Journal of Clinical Hypertension |
| spelling | doaj-art-cfa26ae3e0be42cdbd56c94f45ef60632025-08-20T02:03:07ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-05-01275n/an/a10.1111/jch.70065Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker AdherenceYan Li0Jia‐Yin Sun1Qian‐Yun Guo2Hong‐Ya Han3De‐An Jia4Zhi‐Ming Zhou5Zhi‐Jian Wang6Ying‐Xin Zhao7Yu‐Jie Zhou8Shi‐Wei Yang9Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaDepartment of Cardiology Beijing Anzhen Hospital, Capital Medical University Beijing ChinaBeijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing ChinaBeijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases Beijing ChinaABSTRACT Adherence to antihypertensive medications is essential for blood pressure (BP) control, influencing long‐term outcomes in hypertensive patients. This study examines the association between visit‐to‐visit variability in BP and heart rate (HR) and its effect on adherence to beta‐blocker 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‐month, and 2‐month follow‐up) using standard deviation (SD) and mean‐independent parameters. Nonadherence was defined as medication discontinuation or treatment regimen changes by the 2‐month follow‐up. Among the 9037 patients analyzed, the mean age was 58.85 years (±12.54), and 52.9% were male. Visit‐to‐visit variability in the rate–pressure product (RPP; SBP×HR) was a significant predictor of nonadherence, with an odds ratio (OR) of 1.26 (95% confidence interval [CI]: 1.04–1.53, p < 0.05) for the top‐decile 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: 1.35–2.00, p < 0.001) for DBP and 1.66 (95% CI: 1.39–1.99, p < 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‐to‐visit variability in RPP, DBP, and PP is a significant predictor of nonadherence to beta‐blockers, regardless of mean levels. Addressing this variability is critical for improving adherence to antihypertensive treatments and optimizing patient outcomes.https://doi.org/10.1111/jch.70065blood pressuremedication adherencerate pressure productvisit‐to‐visit variability |
| spellingShingle | Yan Li Jia‐Yin Sun Qian‐Yun Guo Hong‐Ya Han De‐An Jia Zhi‐Ming Zhou Zhi‐Jian Wang Ying‐Xin Zhao Yu‐Jie Zhou Shi‐Wei Yang Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence The Journal of Clinical Hypertension blood pressure medication adherence rate pressure product visit‐to‐visit variability |
| title | Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence |
| title_full | Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence |
| title_fullStr | Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence |
| title_full_unstemmed | Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence |
| title_short | Impact of Variability in Blood Pressure and Heart Rate on Beta‐Blocker Adherence |
| title_sort | impact of variability in blood pressure and heart rate on beta blocker adherence |
| topic | blood pressure medication adherence rate pressure product visit‐to‐visit variability |
| url | https://doi.org/10.1111/jch.70065 |
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