Do general practitioners know enough about FH?

“Raising awareness and recognition of FH (Familial Hypercholesterolemia) is very important. To achieve this, we also need general practitioners,” says Anna van Ittersum of Haaglanden Medical Center (HMC). In young patients, LDL cholesterol levels may appear normal, but they are still elevated for their age. It would be better to look at the age-dependent reference values, which can be found on the LEEFH website. And then offer DNA testing when indicated. It is very important that a family history of the condition be investigated further.

’s Professional Development Since 2011, Anna has been working at Bronovo, now Haaglanden MC, in the internal medicine clinic as a nurse practitioner (NP). Her areas of focus are hypertension, CVRM, and lipids in an outpatient setting. She explains that this is a very challenging job that offers significant professional development; there is close collaboration with internists and other Nurse Practitioners. There are also regular consultations with other specialties, such as cardiologists, pediatricians, and vascular surgeons.

“We want to excel in the care we provide”

Cardiovascular Risk
Through this outpatient care program, the team explores optimal treatment options for cardiovascular risk. The program also places a strong emphasis on lifestyle. The nurse practitioner sees patients independently but consults with the internist regarding each patient at least once.

FH Awareness
‘Anna: “General practitioners assess cardiovascular risk profiles for men over forty and women over fifty. That’s too late for people with FH—by then, vascular damage has already occurred.” For children of a parent with FH, LEEVH recommends testing as early as age six, as they have a 50 percent chance of also having the genetic mutation. People with hereditary high cholesterol are 3 to 5 times more likely to develop vascular disease than people without FH. By treating them early, we can reduce the risk.”

Great job!
“I have a really great job at Haaglanden Medical Center. We want to give high-risk patients the tools they need to live healthy lives and age healthily. We do this with medication, but we also focus a lot on lifestyle: Some of the patients smoke or are overweight. “I work with them to find the best way to improve their lifestyle.”

Excellence in Cardiovascular Care
The nurse practitioner, together with the team, has a very clear goal. “We want to improve patient interaction and the quality of care. We are developing a care pathway for cardiovascular risk management. We want the entire HMC to strive toward the same goal. Collaboration is extremely important.”

Text: Aefke ten Hagen
Photos: Anna van Ittersum