While FH is often caused by known pathogenic or likely pathogenic variants in genes such as the LDL receptor (LDLR), apolipoprotein B-100 (APOB), or Proprotein convertase subtilisin/kexin type 9 (PCSK9), many cases involve variants of uncertain significance (VUS) [3]. This evidence concerns the gene PCSK9 and familial hyperaldosteronism.