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Getting insurance after genetic screening on familial hypercholesterolaemia; the need to educate both insurers and the public to increase adherence to national guidelines in the Netherlands
  1. P J Marang-van de Mheen,
  2. M C van Maarle,
  3. M E A Stouthard
  1. Department of Social Medicine, Academic Medical Centre, Amsterdam, the Netherlands
  1. Correspondence to:
 Dr P J Marang-van de Mheen, Department of Medical Decision Making, K6-R, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, the Netherlands;


Heterozygous familial hypercholesterolaemia (FH) is a common autosomal dominant inherited metabolic disease with a prevalence of 1 in 500 in most Western countries.1–3 People with FH experience an increased risk for coronary artery disease (CAD) and excess mortality especially at a young age.4,5 Until recently the diagnosis of FH was based on clinical signs and symptoms alone. These included increased cholesterol concentrations, in particular of LDL-cholesterol, in combination with the presence of tendon xanthoma, corneal arcus, xanthelasmata and a history of early CAD. Frequently FH was diagnosed after a first cardiac event.

  • familial hypercholesterolaemia
  • screening
  • insurance
  • FH, familial hypercholesterolaemia
  • CAD, coronary artery disease

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  • Funding: this study was funded by the Health Research and Develop-ment Council (grant number 28-2751).

  • Conflicts of interest: none.