Atherosclerotic plaques located in the proximal and middle portions of the coronary arteries have been described in adult patients with heterozygous familial hypercholesterolemia.4 Experimental studies showed that hypercholesterolemia can lead to cardiac hypertrophy by several mechanisms,16,17 such as increased plasma concentration of endothelin-1, leading to vasomotor alterations, activation of the hypertrophic signaling pathways in cardiomyocytes, and increased cardiac oxidative stress. Here, EDN1 is linked to cardiac hypertrophy.