CYP3A4 and familial hypercholesterolemia: CYP3A4*3, *7, *9, *10 and *19 also did not change enzyme activity, while CYP3A4 *2, *7, *16 and *17 caused substrate specific changes in enzyme activity [25,47,48,49] CYP3A4*3 was associated with lower levels of low-density lipoprotein cholesterol in hypercholesterolemia patients but lacking a cogent mechanistic interpretation [50], and with a higher HDL increase upon fluvastatin treatment [51].