Slowing down the atherosclerosis process would likely require years of sustained improvement in risk factors for atherosclerotic cardiovascular disease (ASCVD).1 SGLT2 inhibitors significantly reduce hospitalization for heart failure, atherosclerotic events, cardiovascular, and total mortality as well as progression of chronic kidney disease.2,3 However, the reductions in adverse cardiovascular outcomes and hospitalizations for heart failure observed in clinical trials had an earlier onset than anticipated by an effect in reducing atherosclerosis. The gene discussed is SLC5A2; the disease is heart failure.