Uitkomstgericht cardiovasculair risicoframework nodig na dwarslaesie

Blood pressure (BP) instability is a hallmark of disrupted autonomic cardiovascular control after spinal cord injury (SCI). Individuals frequently experience hypertensive surges during autonomic dysreflexia and hypotensive drops during orthostatic hypotension, yet the commonly used thresholds for defining these events are derived from expert consensus rather than outcome-based evidence. Similarly, arterial stiffness, typically assessed by pulse wave velocity, is consistently elevated in SCI, but no validated cut points exist to guide clinical intervention. This lack of outcome-anchored thresholds limits risk stratification and leaves clinicians without tools to evaluate the cumulative cardiovascular burden imposed by chronic hemodynamic instability. Accumulating data indicate that individuals with SCI demonstrate profound BP variability, particularly those with cervical or high thoracic injuries, and exhibit higher rates of ischemic heart disease, stroke, and sudden cardiac death compa