While there is compelling evidence that a very low level of LDL-C may increase the risk of haemorrhagic stroke [18], especially in Asians [19], it is pertinent that there was no increase in risk at very low LDL-C levels attained by adding ezetimibe [3] or a PCSK9 inhibitor [4, 5] to background statin therapy in major clinical trials. This evidence concerns the gene PCSK9 and hemorrhagic stroke.