Serum low-density lipoprotein cholesterol (LDL-C) is the major causal factor underlying ASCVD, and although statins and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors enable effective control of LDL-C in hypercholesterolaemic patients with ASCVD, dietary and other lifestyle measures will remain the backbone of LDL-C control at the population level [3]. This evidence concerns the gene PCSK9 and atherosclerosis.