{"id":"4b1c6436e78a","type":"article","url":"https://hartvaat.nl/2018/08/01/zelfmanagement-van-postnatale-hypertensie-de-snap-ht-trial/","title":"Zelfmanagement van postnatale hypertensie: de SNAP-HT-trial","title_en":"Self-Management of Postnatal Hypertension: The SNAP-HT Trial.","category":"hypertensie","category_label":"Hypertensie","professions":["huisarts"],"tags":["bloeddrukbehandeling","zwangerschap-hart"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.118.10911","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.118.10911","authors":["Alexandra E Cairns","Katherine L Tucker","Paul Leeson","Lucy H Mackillop","Mauro Santos","Carmelo Velardo","Dario Salvi","Sam Mort","Jill Mollison","Lionel Tarassenko","Richard J McManus"],"significance":6,"published":"2018-08-01","source_date":"2018-08-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-zwangerschap/","https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/"],"congress":"","summary_en":"The SNAP-HT trial of blood pressure self-management in the postpartum period after hypertensive pregnancy demonstrated that self-monitoring enables better titration of antihypertensives during the rapidly changing post-delivery period.","created":"2026-07-03T10:27:24Z","updated":"2026-07-03T18:38:39Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"SNAP-HT gerandomiseerde trial naar zelfmanagement van bloeddruk in de postnatale periode bij vrouwen met hypertensieve zwangerschapscomplicaties.","abstract_original":"UNLABELLED: Hypertension affects 1 in 10 pregnancies, often persisting postpartum, when antihypertensive requirements may vary substantially. This unmasked, randomized controlled trial evaluated the feasibility and effects on blood pressure (BP) of self-management of postpartum hypertension. Women with gestational hypertension or preeclampsia, requiring postnatal antihypertensive treatment, were randomized to self-management or usual care. Self-management entailed daily home BP monitoring and automated medication reduction via telemonitoring. Women attended 5 follow-up visits during 6 months. The primary outcome was feasibility: specifically recruitment, retention, and compliance with follow-up rates. Secondary outcomes included BP control and safety, analyzed on an intention-to-treat basis. Forty-nine percent (91/186) of those women approached were randomized (45 intervention, 46 control), and 90% (82/91) finished follow-up. The groups had similar baseline characteristics. After randomization, BP was lower in the intervention group, most markedly at 6 weeks: intervention group mean (SD), systolic 121.6 (8.7)/diastolic 80.5 (6.6) mm Hg; control group, systolic 126.6 (11.0)/diastolic 86.0 (9.7) mm Hg; adjusted differences (95% confidence interval), systolic -5.2 (-9.3 to -1.2)/diastolic -5.8 (-9.1 to -2.5) mm Hg. Diastolic BP remained significantly lower in those self-managing to 6 months: adjusted difference -4.5 (-8.1 to -0.8) mm Hg. This is the first randomized evaluation of BP self-management postpartum and indicates it would be feasible to trial this intervention in larger studies. Self-management resulted in better diastolic BP control to 6 months, even beyond medication cessation. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT02333240."}