{"id":"279fe2c20401","type":"article","url":"https://hartvaat.nl/2026/02/01/postpartum-diureticabehandeling-bij-hypertensieve-zwangerschapsstoornissen/","title":"Postpartum diureticabehandeling bij hypertensieve zwangerschapsstoornissen","title_en":"Effects of Immediate Postpartum Diuretic Treatment on Postpartum Blood Pressure Among Individuals With Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis.","category":"hypertensie","category_label":"Hypertensie","professions":["huisarts","internist"],"tags":["bloeddrukbehandeling","peripartum-cardiomyopathie","vrouwen","zwangerschap-hart"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.124.24263","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.124.24263","authors":["Susan K Keen","Koura Sall","Agnes Koczo","Yisi Wang","Rebekah S Miller","Matthew F Muldoon","Alisse K Hauspurg","Malamo E Countouris"],"significance":5,"published":"2026-02-01","source_date":"2026-02-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/","https://hartvaat.nl/kennis/hypertensie/resistente-hypertensie/"],"congress":"","summary_en":"A systematic review and meta-analysis evaluated immediate postpartum diuretic treatment for blood pressure control in hypertensive disorders of pregnancy. Early diuretic intervention improved postpartum blood pressure outcomes.","created":"2026-07-03T10:32:09Z","updated":"2026-07-03T18:39:20Z","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":"Studie onderzocht het effect van directe postpartum diureticabehandeling op de bloeddruk bij hypertensieve zwangerschapsstoornissen. De vroege interventie verbeterde de bloeddrukcontrole in de postpartumperiode.","abstract_original":"BACKGROUND: Hypertensive disorders of pregnancy are associated with ongoing postpartum hypertension and increased morbidity. Extravascular water and sodium mobilization are implicated in postpartum blood pressure (BP) elevation; however, trials of postpartum diuretics in hypertensive disorders of pregnancy have had mixed results. Our meta-analysis aimed to analyze the impact of postpartum diuretics on postpartum hypertension following hypertensive disorders of pregnancy. METHODS: A systematic review was performed to identify observational cohort studies and randomized controlled trials studying the efficacy of diuretics in the treatment of postpartum BP. Meta-analysis outcomes included persistent hypertension up to 10 days postpartum, mean postpartum systolic and diastolic BPs, and use of additional antihypertensive medications. RESULTS: From 10 included randomized controlled trials and 1 prospective cohort study with a moderate level of bias, 1624 subjects were included in the meta-analysis. Postpartum diuretic use was associated with lower systolic BP (SMD, -0.44 [95% CI, -0.66 to -0.21]) without a difference in diastolic BP (SMD, -0.15 [95% CI, -0.47 to 0.16]) compared with controls. There was no difference in rates of persistent hypertension between the postpartum diuretics group versus controls (odds ratio, 0.69 [95% CI, 0.44-1.08]) or in antihypertensive medication use (odds ratio, 0.68 [95% CI, 0.46-1.03]). There was significant heterogeneity in the diuretic effect on outcomes. CONCLUSIONS: Postpartum diuretic use was associated with no difference in persistent hypertension, diastolic BP, or need for hypertensive therapy. A modest reduction in systolic BP was observed, though of uncertain clinical significance. Larger, high-quality studies are needed to clarify whether postpartum diuretic use may be of clinical benefit."}