# Cardio-hepatologische zorg: nieuwe medicijnen helpen, maar zorgongelijkheid blijft

*geplaatst 2026-10-11 · Hartfalen · Current cardiology reports · doi 10.1007/s11886-026-02426-9 · https://hartvaat.nl/2026/10/03/cardio-hepatologische-zorg-nieuwe-medicijnen-helpen-maar-zorgongelijkheid-blijft/*

Deze narratieve review belicht de sterke cardiometabole link tussen MASLD en cardiovasculaire aandoeningen, waarbij gedeelde inflammatoire en metabole pathways de oorzaak zijn van verhoogde morbiditeit. Hoewel nieuwe therapieën zoals resmetirom en semaglutide het behandelarsenaal uitbreiden, worden vroegtijdige herkenning en fibroscreening vaak geremd door structurele ongelijkheden, verschillen in zorgtoegang en socio-economische barrières. Voor de klinische praktijk betekent dit dat een gestructureerd cardio-hepatologisch kader met focus op individuele risicoprofilering en gelijke toegang tot niet-invasieve diagnostiek en medicatie essentieel is om de cardiometabole uitkomsten te verbeteren.

## English: Comorbid Cardiovascular-Liver Disease Disparities: Current Understanding and Future Directions.

This narrative review highlights the strong cardiometabolic link between MASLD and cardiovascular disease, driven by shared inflammatory and metabolic pathways that significantly increase morbidity. While novel agents such as resmetirom and semaglutide expand therapeutic options, timely diagnosis and fibrosis assessment are frequently hindered by structural inequities, limited care access, and socioeconomic barriers. Clinicians should adopt an integrated cardio-hepatology approach that prioritizes individualized cardiovascular risk reduction, stepwise noninvasive fibrosis evaluation, and equitable access to indicated therapies to improve long-term outcomes.

## Abstract (original, from the publication)

PURPOSE OF REVIEW: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent chronic liver disease and a multisystem cardiometabolic disorder. Cardiovascular disease (CVD) is a major cause of morbidity and mortality in this population. This review examines disparities in the recognition and management of coexisting cardiovascular and metabolic liver disease. RECENT FINDINGS: Shared metabolic and inflammatory pathways link liver disease with obesity, type 2 diabetes, hypertension, and CVD. Differences in measured disease prevalence across racial and ethnic groups must be interpreted separately from genetic susceptibility and in the context of structural inequities, diagnostic practices, and access to care. Socioeconomic disadvantage and sex- and gender-related barriers may further affect diagnosis and treatment. Resmetirom and semaglutide have expanded treatment options for selected adults with metabolic dysfunction-associated steatohepatitis (MASH), but unequal access to fibrosis assessment, insurance coverage, and longitudinal care may limit their benefits. An equity-centered cardio-hepatology framework should integrate early risk identification, stepwise noninvasive fibrosis assessment, individualized cardiovascular prevention, and access to indicated liver-directed therapies. Treatment and quality measures should reflect clinical eligibility rather than medication use alone. Inclusive research and coordinated long-term care are needed to evaluate whether these strategies narrow disparities.

Auteurs: Abdelrahman Hafez, Mohamed Nour, Ramzi Ibrahim, Jenna Othman, Mohamed Reyad Mohamed, Kamal Awad, Julia Zanco, Vinicius De Sousa Barzon Serra, Mahmoud Abdelnabi, Mahmoud Elbsiony, Said Alsidawi, Steven J Lester, Chadi Ayoub, Reza Arsanjani

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Bron: Current cardiology reports, https://doi.org/10.1007/s11886-026-02426-9. Bijgewerkt 2026-10-04T01:16:04Z. 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.