levels< 200 mg/dl). Subclinical atherosclerosis was present in 49.7% of participants, as detected with noninvasive imaging (2D vascular ultrasound and noncontrast cardiac CT). After assessing serum biomarkers and physical and lifestyle parameters, the researchers found that, together with age and male sex, LDL-C level was the main predictor of the presence and extent of atherosclerotic plaques in both groups (OR (× 10 mg/dl) 1.14–1.18, P< 0.01).“Our findings reaffirm the importance of aggressively reducing LDL-C levels,” say Fuster and Sanz,“and might have important implications for primordial prevention strategies at both the individual and societal levels.” The PESA investigators will continue to follow up study participants to assess whether these findings correlate with clinical outcomes.