Apolipoprotein B containing lipoproteins—mainly low-density lipoprotein cholesterol (LDL-C)—have indubitably been shown to be causal for atherosclerosis, and interventions that lower LDL-C can change the trajectory of the disease to improve cardiovascular outcomes.1 With the ever-expanding armamentarium of lipid lowering therapies, it becomes important to decide to whom, when, and how to administer these therapies optimally. This evidence concerns the gene APOB and atherosclerosis.