Thanks for sharing your thoughts, Rose. I have to dampen the enthusiasm about the genetic component of our major chronic diseases. While several hundred genes have been identified in genome-wide association studies (GWAS) to somehow correlate with the diseases, their contributions are too small to blame them as the major culprits, and we don't understand their interactions either.

The major blow to the genetic argument comes from another observation, though. When traditionally living tribes with very low CVD incidence rates are exposed to Western lifestyles, their incidence rates increase sharply. These effects have been observed in independent locations in South America, Africa, and Asia. So, lifestyle factors reign supreme. As far as Lp(a) is concerned, yes, it is a heritable factor that accentuates risk in the scenario of lifestyle-dependent elevated CVD risk. But that risk accentuation can be neutralized by appropriate lifestyle changes.