{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:52:34Z","timestamp":1791478354528,"version":"4.3.4"},"reference-count":30,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Med Princ Pract"],"abstract":"<jats:p>Objectives: This retrospective cohort study evaluated the real-world clinical effects of four dual-combination antihypertensive regimens on 24-h ambulatory blood pressure variability (BPV) and circadian rhythm modifications over a 24-week period. Methods: A total of 302 adults with primary hypertension were evaluated across parallel cohorts: an angiotensin-converting enzyme inhibitor plus calcium channel blocker group (ACEi+CCB, n = 76), an angiotensin II receptor blocker plus thiazide diuretic group (ARB+Thiazide, n = 75), a \u03b2-blocker plus thiazide group (BB+Thiazide, n = 74), and a calcium channel blocker plus \u03b2-blocker group (CCB+BB, n = 77). A 24-h systolic blood pressure (SBP) standard deviation, coefficient of variation (CV), and night-to-day SBP ratios were analyzed to assess hemodynamic variations independent of absolute blood pressure lowering. Results: While all regimens significantly reduced mean office and 24-h ambulatory blood pressure, the ACEi+CCB combination demonstrated a significantly greater reduction in the 24-h systolic CV from baseline to week 24 (from 10.35% \u00b1 1.25% to 7.45% \u00b1 0.92%, a relative drop of \u221228.0%) compared to the ARB+Thiazide (\u221215.1%), CCB+BB (\u221214.4%), and BB+Thiazide (\u22124.8%) cohorts (p &lt; 0.001 after adjusting for absolute BP reduction). Additionally, the ACEi+CCB group achieved a significant downward shift in the continuous night-to-day SBP ratio from 0.96 \u00b1 0.04 to 0.91 \u00b1 0.03 (p &lt; 0.001), outperforming the ARB+Thiazide and BB+Thiazide arms. Treatment compliance (92%\u201395%) and overall adverse event rates (7.1%\u20139.7%) remained comparable across all groups. Conclusion: Dual therapies show class-dependent effects on BPV and circadian rhythm; ACEi+CCB most effectively reduces 24-h systolic fluctuations.<\/jats:p>","DOI":"10.1159\/mpp\/adpag009","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T13:02:51Z","timestamp":1786021371000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effect of Dual-Combination Antihypertensive Regimens on Reducing 24-Hour Systolic Blood Pressure Variability and Modifying Nocturnal Dipping Shifts: A Retrospective Cohort Study"],"prefix":"10.1159","author":[{"given":"Dan","family":"Shan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuxiu","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfang","family":"Niu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiawei","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-e","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines14020317"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1080\/08037051.2025.2521523"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf546"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000004153"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-026-05039-x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1002\/cnm.70148"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1713230"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/jch.70050"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/nu18020334"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.46234\/ccdcw2025.116"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2196\/81148"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2024.10.022"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1080\/08037051.2025.2510317"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.125.25462"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-024-02070-2"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1111\/jch.14870"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.18203\/2349-3933.ijam20261093"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1002\/hsr2.71739"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1372505"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1038\/s41397-024-00333-2"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1097\/CRD.0000000000000644"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-023-01091-9"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000249"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.26599\/1671-5411.2025.01.008"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-025-01159-z"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.pharmthera.2025.108875"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0000000000004140"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.4390"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.13812"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)01786-X"}],"container-title":["Medical Principles and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/mpp\/adpag009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:03:38Z","timestamp":1791475418000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/mpp\/adpag009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,20]]},"references-count":30,"URL":"https:\/\/doi.org\/10.1159\/mpp\/adpag009","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.33183335","asserted-by":"subject"}]},"ISSN":["1011-7571","1423-0151"],"issn-type":[{"value":"1011-7571","type":"print"},{"value":"1423-0151","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,20]]}}}