Familial hypercholesterolemia (FH) is defined by its phenotype, not solely by a genetic abnormality, and this phenotype confers a significantly higher residual risk.

“now that study's been accepted by everybody as being well done and decisive and um and i mean by everybody everybody just to make sure i understand what you said you can have two patients who are phenotypically identical but the one who has the genetic abnormality of fh which is simply a phenotypic disease by the way it's not a genetic it's a it's a the disease is defined by the phenotype you're saying they carry a residual risk that's not present in the wild type that's correct three to five times that risk 300 percent”