In both human and animal studies, it has been revealed that the inherent lack of PCSK9 circulating in the bloodstream does not cause noticeable pathological conditions.21,69–71,122,123 Two unrelated Canadian patients suffering from FH and who were resistant to intensive statin intervention, exhibited the completely duplicated PCSK9 gene.124 Individuals with elevated PCSK9 experienced substantial increases in LDL-C levels and early onset of CVEs, with one having PCSK9 levels about 20 times the standard. Here, PCSK9 is linked to familial hyperaldosteronism.