Dahl et al. [17], who were among the first to document a decreased cardiovascular risk in the large Copenhagen City Heart Study cohort, proposed the hypothesis that alterations in the proportion of elastin in large elastic arteries could be attributed to the unrestricted elastase activity within the vessel wall of AATD patients, and that this may affect their distensibility, potentially leading to a decrease in blood pressure. Here, ELN is linked to alpha 1-antitrypsin deficiency.