Visual In conversation with Anna Vissers and Marian Seger from Rijnstate

A conversation with Anna Vissers and Marian Seger of Rijnstate

  • October 20, 2021
  • Familial Hypercholesterolemia, The people of LEEFH, Regional LEEFH centers

Marian Seger and Anna Vissers have been working together for years as diabetes vascular nurses at the vascular center at Rijnstate Hospital in Arnhem. They are both specialized nurses, and their area of focus is Familial Hypercholesterolemia. We spoke with them about their work at the LEEFH Center.

As specialized nurses, FH consultants Anna Vissers and Marian Seger see various patients at increased risk of cardiovascular disease. The two professionals work together in a team of 15 colleagues and each have their own office hours. During these times, they also meet with people who have Familial Hypercholesterolemia: a hereditary condition characterized by high cholesterol. This condition can have far-reaching consequences if left untreated. 

The nurses speak enthusiastically about their work: “Once patients have been diagnosed with FH, providing them with information is very important. We work closely with the vascular internist on this. As nurses, we explain FH to patients and provide them with information about it, with family history screening being a key part of this. We also maintain close contact with Leefh on this matter.”

“We want to get people moving” 

Lifestyle and medication
Nurses cite smoking, obesity, diet, and exercise as major risk factors. Psychological factors and stress also play a role. "During the coronavirus pandemic, we have seen that it is particularly difficult for patients to maintain a healthy lifestyle. In that sense, coronavirus has certainly played a role in the health of our patients."


The pair are enthusiastic about the new GLI lifestyle program. Combined Lifestyle Intervention is a program that people who want to improve their lifestyle can follow. This program is reimbursed by health insurers. It focuses on sleep, stress, quitting smoking, healthy eating, and exercise. This program has a positive effect if a patient is motivated. When asked whether specialized nurses also play a role in motivating a healthy lifestyle, they both answer with a resounding "yes!" "That is definitely part of our job. We enjoy being able to get people moving. Sometimes, contrary to our expectations, a patient has quit smoking. That is wonderful, of course."


family research Vissers and Seger both enjoy providing information to patients. Every patient is unique. They explain: "The trick is to get the patient moving. Tailor your information to the patient's situation and capabilities. For FH patients, lifestyle changes alone are insufficient because their genetic background causes them to have high cholesterol. As a result, they generally need medication. And you can't feel high cholesterol. People don't immediately suffer from it if they don't take their medication. It's our job to educate and advise them properly. Ultimately, of course, people have to do it themselves."

“A healthy lifestyle alone is not enough” 

Vissers concludes: “It’s also very important to realize that you can be a carrier of the FH gene without having sky-high cholesterol. Raising awareness about this and explaining the importance of family screening are extremely important.”

Text: Aefke ten Hagen
Photos: Anna Vissers and Marian Seger 

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