A Conversation with Inge Boullart – Internist and Vascular Specialist at VieCuri Hospital

Of course, it's not pleasant news when someone is diagnosed with FH, but I always add that it's easily treatable.

Inge Boullart has been working as an internist-vascular physician at the VieCuri hospital in Venlo and Venray since 2013. "Of course, it's not good news when someone is diagnosed with FH, but I always add that it's easily treatable."

The great thing about working with people with FH is that it involves a large group of people who, although they have a

have hereditary high cholesterol, but remain healthy thanks to treatment and a healthy lifestyle," begins the internist-vascular physician. "By coaching and advising them, I can help ensure that they don't end up with my colleagues in cardiology, neurology, or vascular surgery with heart or vascular disease. It's a very rewarding job and a very enjoyable one." Most patients wave goodbye to the doctor after treatment, but she continues to see people with FH for years. This creates a special bond, even if they have long since moved to another region.

Patients can, of course, transfer to another LEEFH center, but that is not necessary. The coronavirus pandemic has introduced us to online consultations. Previously, we did not believe this was feasible, but it has proven to be a very accessible form of contact between doctor and patient. I see that people who move away make use of it. Of course, they still come in for examinations from time to time, but you can also catch up very well via the computer. This way, you keep a family together in one center, and I notice that people like that. For me as a doctor, this is also true, because you know what is going on with FH among family members.'

Risk management

Part of Inge's work involves risk management. She takes a very targeted approach with people who have FH. "Of course, it's not good news when someone is diagnosed with FH, but I always emphasize that it's treatable. Together with the patient, I look for a good lifestyle and medication to keep their cholesterol levels under control. It's really a collaboration between me as a doctor and the patient." Sometimes it takes a while to find the right treatment. "Some people with FH are statin-intolerant. They are eligible for PCSK9 inhibitors, which is a huge benefit. It is an expensive medication that people normally only receive if they already have cardiovascular disease. With FH, you don't have to wait for a heart attack; patients are eligible for PCSK9 inhibitors earlier, so that prevention is optimal.'

Hospital laboratory

The LEEFH center at VieCuri Hospital has a good working relationship with general practitioners in the region. If GPs request blood tests themselves and the hospital lab finds high LDL or high cholesterol, the GP is given a warning to "consider FH." 'We have been doing this for about six years now, which means that more people with FH are being identified and referred to us. That is obviously a positive development. Because knowing that you have FH means that you can do something about it.'

Awareness

According to Inge Boullart, the fact that VieCuri is a regional LEEFH center offers considerable added value. Not only in terms of recognition for patients. "We take the time to counsel patients. As an internist-vascular physician, I do this myself; we don't currently have a nurse specialist for this. I talk to people about healthy lifestyles, nutrition, and exercise, as well as medication. As a LEEFH center, we have a lot of affinity with and knowledge about FH. We also organize symposiums for patients in the area and for healthcare professionals. This increases awareness in the community; awareness that there is good care available for people with FH and that it is important to know whether this is an issue for you and your family."