# Hypertensie tijdens de zwangerschap en langdurig hart- en vaatrisico bij inheemse bevolking in de VS

*geplaatst 2026-09-12 · Hypertensie · Current hypertension reports · doi 10.1007/s11906-026-01383-6 · https://hartvaat.nl/2026/09/04/hypertensie-tijdens-de-zwangerschap-en-langdurig-hart-en-vaatrisico-bij-inheemse/*

Een narratieve review toont aan dat inheemse vrouwen in de Verenigde Staten een aanzienlijk hoger risico lopen op hypertensieve zwangerschapsaandoeningen (9,1%) en ernstige maternale morbiditeit, mede door een hoge prevalentie van obesitas en metabool syndroom. Naast individuele risicofactoren spelen structurele ongelijkheden, culturele bias en gebrek aan postpartumfollow-up een cruciale rol in het tweevoudig verhoogde risico op langdurige cardiovasculaire ziekte. Voor de klinische praktijk benadrukt de review de noodzaak van vroegtijdige preventie, gestructureerde bloeddrukcontrole en het overwinnen van systemische barrières om de lange termijn cardiorenale en cardiovasculaire uitkomsten te verbeteren.

## English: Indigenous Health Disparities in Hypertensive Disorders of Pregnancy Within the United States.

A narrative review highlights that American Indian and Alaska Native women face a disproportionately high prevalence of hypertensive disorders of pregnancy (9.1%) and a 1.6-fold higher rate of severe maternal morbidity, driven by both high rates of cardiometabolic comorbidities and systemic structural inequities. Despite a two-fold increased long-term cardiovascular disease risk following hypertensive pregnancy complications, this population encounters significant barriers to postpartum cardiovascular screening and preventive care. The review underscores the need for culturally concordant care, structured postpartum follow-up, and community-led research to address these disparities and mitigate long-term cardiometabolic risk.

## Abstract (original, from the publication)

PURPOSE OF REVIEW: This review examines determinants across structural, institutional, interpersonal, and individual domains that contribute to hypertensive disorders of pregnancy (HDPs) in American Indian and Alaska Native (AI/AN) populations and their long-term cardiovascular consequences. It suggests paths forward for equitable research and clinical practice. RECENT FINDINGS: AI/AN women have the highest HDP prevalence among all racial and ethnic groups at 9.1% and experience severe maternal morbidity at 1.6 times the rate of non-Hispanic white women. Pre-existing cardiometabolic disease, including obesity affecting 40% and metabolic syndrome affecting up to 55% of AI/AN adults, compounds pregnancy risk. Beyond individual factors, structural determinants, such as the legacy of colonization, racial misclassification, violations of tribal data sovereignty, and disrupted traditional birthing practices, have perpetuated systemic barriers and health inequities. Qualitative evidence documents pervasive discrimination, cultural dismissiveness, and provider bias during perinatal care. Despite the 2-fold increased long-term cardiovascular disease risk from HDPs, AI/AN women face persistent barriers to postpartum follow-up and cardiovascular screening. Effective evidence-based preventive strategies, including low-dose aspirin prophylaxis, blood pressure management, and telehealth-based postpartum monitoring, remain understudied in AI/AN populations. Addressing HDP disparities in AI/AN populations requires moving beyond individual risk factors to confront structural determinants. Meaningful progress requires community-based participatory research that centers tribal data sovereignty, incorporation of Indigenous scholars into research leadership, and policy-level changes. Ultimately, these efforts may expand culturally concordant perinatal care, reduce acute maternal morbidity, and reduce long-term HDP-related cardiovascular risk.

Auteurs: Thoai T Vu, Haley E Watts, Claudia Meyer, Irena Kuzma, Katelyn Baggett, Biak L Tial, Theresa Boyer, Phebe Ismail, Erin D Michos, Allison G Hays, Anum S Minhas

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Bron: Current hypertension reports, https://doi.org/10.1007/s11906-026-01383-6. Bijgewerkt 2026-09-06T00:54:23Z. 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.