{"id":"9d39175f3bdc","type":"article","url":"https://hartvaat.nl/2026/02/24/uitkomstgericht-cardiovasculair-risicoframework-nodig-na-dwarslaesie/","title":"Uitkomstgericht cardiovasculair risicoframework nodig na dwarslaesie","title_en":"Outcome-Based Cardiovascular Risk Framework is Required After Spinal Cord Injury","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","internist"],"tags":["acuut-hartfalen","aficamten","aortainsufficiëntie","biomarkers-cardiovasculair","bloeddrukbehandeling","bradycardie","cardiomyopathie-gerichte-therapie","diabetes-en-hart","diabetes-type-2","gedilateerde-cardiomyopathie","hypertrofische-cardiomyopathie","inflammatie","laminopathie","menopauze","microbioom","obesitas","ouderen","perifeer-vaatlijden","richtlijnen-esc","slaapapneu","supraventriculaire-tachycardie"],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26543","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26543","authors":["Armin Khavandegar"],"significance":6,"published":"2026-02-24","source_date":"2026-02-24","image":"","kennis":[],"congress":"","summary_en":"This article highlighted the need for an outcome-based cardiovascular risk framework after spinal cord injury, where blood pressure instability and autonomic dysfunction create unique cardiovascular challenges.","created":"2026-07-03T10:25:17Z","updated":"2026-07-03T18:38:14Z","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":"Bloeddrukinstabiliteit is kenmerkend voor verstoorde autonome cardiovasculaire controle na dwarslaesie, met hypertensieve pieken bij autonome dysreflexie en hypotensie bij houdingsverandering. Dit artikel pleit voor een uitkomstgericht risicoframework.","abstract_original":"Hypertension, Volume 83, Issue 4, Page e26543, April 1, 2026. 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 "}