Currently, in Japan, the guidelines, such as the Japanese Circulation Society 2023 guideline on primary prevention of coronary artery disease, the Japan Atherosclerosis Society 2022 guidelines for prevention of atherosclerotic cardiovascular disease, and the Japanese Circulation Society 2018 guideline on diagnosis of chronic coronary heart diseases,14 have acknowledged the potential association between high Lp(a) and the risk of atherosclerotic disease.14, 15, 16 However, they do not define specific thresholds for high Lp(a). This evidence concerns the gene LPA and atherosclerosis.