A conversation with Mattijs Out, internist and vascular specialist at Medisch Spectrum Twente

Dr. Mattijs Out is a vascular medicine specialist at Medisch Spectrum Twente. He discusses the treatment of people with FH at his hospital.

At Medisch Spectrum Twente (MST), there is a small and dedicated team working in the field of FH, consisting of a pediatrician, a cardiologist, a clinical chemist, and two vascular internists, one of whom is Mattijs Out. He describes himself as a doctor who prefers not to prescribe medication. This stems from his passion for lifestyle medicine. "In recent years, there has been an increasing focus on lifestyle," he says. "It's great when a patient manages to resolve their symptoms themselves by living a healthier life. FH is a separate chapter in my work, because these patients cannot do without medication. The LDL cholesterol that is high in FH can hardly be influenced by lifestyle. It is largely determined by genetic predisposition. People are born with this predisposition, and we cannot change it. This automatically means that you have to rely on medication if you want to get your LDL levels right."

This does not mean that lifestyle does not play a role in FH. "For people who are unfortunate enough to have FH, a healthy lifestyle is even more important than for people who do not have this condition. It is not the way to lower cholesterol levels, but it is the way to keep the arteries healthy. In addition, it is extremely important not to smoke. This does not affect your cholesterol levels so much, but it does greatly reduce the risk of a heart attack or stroke."

Lifestyle portal

Patients at MST can use the lifestyle portal. During office hours, a lifestyle expert is available to provide advice. "This could be a lifestyle coach or an exercise coach who takes the time to talk to people and give them tips. If someone needs more guidance to change their lifestyle or wants to quit smoking, we look at what support options are available."

Medication

When treating people with FH, it can sometimes be challenging to convey the importance of medication, according to Mattijs. "It depends a little on who I'm talking to," he explains. "If someone has a family member who has had a heart attack, then the importance is usually self-evident. If this is not the case, I try to calmly and clearly explain what FH is and what the consequences are. I also always refer to the LEEFH website www.leefh.nl, which explains very well what FH treatment entails. Furthermore, scientific research shows how enormously positive the effect of treatment is. This helps to reinforce the message that, thanks to that daily pill, people can live to a ripe old age, as long as they start taking it in time. Preferably in children from the age of eight."

Family

Mattijs cites family research as another challenge in his work. "If we discover that someone has FH, it is essential that their family members also know this. They have a fifty percent chance of having FH. DNA testing can determine this. It is great that LEEFH has taken on the task of informing families and tracking down people with FH. Every so often, we receive an overview of the people who have been reached. If people have not responded to the information from LEEFH, we bring it to their attention again. Basically, we just tell them that knowing you have FH can save your life. It's a very simple but extremely important message."