Nocturnal Stage 1 Hypertension Defined by 2025 Guidelines in Adults With Chronic Kidney Disease

Importance: The 2025 American College of Cardiology/American Heart Association (ACC/AHA) blood pressure (BP) guideline introduced new hypertension criteria. However, the association between newly defined nocturnal stage 1 hypertension (nocturnal BP 110-120/65-70 mm Hg) and kidney function progression in the population not receiving dialysis with chronic kidney disease (CKD) in China remains unclear. Objective: To determine whether nocturnal stage 1 hypertension as defined by 2025 ACC/AHA guidelines in patients with CKD is associated with kidney function progression. Design, Setting, and Participants: A retrospective cohort study involving patients with CKD not receiving dialysis was conducted in China at the Third Affiliated Hospital of Sun Yat-sen University from August 2010 to December 2017 and at the Fifth Affiliated Hospital of Sun Yat-sen University from November 2017 to December 2024. Exposure: Participants were categorized into 3 groups based on nocturnal BP measurements according to the 2025 ACC/AHA guidelines: nonhypertension (nocturnal BP