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We evaluated associations between antihypertensive medication classes and ABPM profiles by conducting a cross-sectional analysis of participants from the Chronic Renal Insufficiency Cohort (CRIC) with ABPM data. Antihypertensive medications were categorized as renin-angiotensin system inhibitors (RASis), beta-blockers, calcium channel blockers (CCBs), and thiazide\/loop diuretics. We used multinomial logistic regression to evaluate the independent association between each medication class (accounting for simultaneous use of multiple classes) and ABPM phenotype: controlled hypertension, white coat effect, sustained hypertension, and masked uncontrolled hypertension (MUCH). Secondary outcomes included nocturnal hypertension, nocturnal non-dipping, and BP variability. Analyses were Bonferroni-corrected for multiple comparisons. Among 1499 eligible participants, 66% used RASis, 52% beta-blockers, 43% CCBs, and 50% thiazide\/loop diuretics. RASi use was associated with lower odds of sustained hypertension (OR 0.60, 95% CI 0.42 to 0.84), while beta-blocker use was positively associated with MUCH (OR 1.48, 95% CI: 1.12 to 1.96). For secondary outcomes, RASi use was associated with lower odds of nocturnal hypertension (OR 0.71, 95% CI: 0.55 to 0.91), whereas beta-blocker and CCB use were both associated with nocturnal hypertension (OR for beta-blockers 1.33, 95% CI 1.04 to 1.70; OR for CCBs 1.36, 95% CI 1.07 to 1.73). Overall, we identified several associations between specific antihypertensive classes and abnormal ABPM profiles. Longitudinal studies are needed to evaluate reproducibility and potential mechanisms of these findings.<\/jats:p>","DOI":"10.1038\/s41371-026-01166-1","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:49:01Z","timestamp":1780717741000},"page":"631-639","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Relationship between medication class and ambulatory blood pressure profile in the chronic renal insufficiency cohort (CRIC) study"],"prefix":"10.1038","volume":"40","author":[{"given":"Sachin V.","family":"Pasricha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie L.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Shulman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4673-7118","authenticated-orcid":false,"given":"Rushelle","family":"Byfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4649-079X","authenticated-orcid":false,"given":"Jordana B.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"CRIC Study Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda H.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J.","family":"Appel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debbie L.","family":"Cohen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Dember","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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DLC, RB, RS, and JBC have no relevant financial conflicts of interest to declare.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}},{"value":"This study was approved by the University of Pennsylvania Institutional Review Board No. 853884. The study was conducted with full adherence to the principles outlined in the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Ethics"}}]}}