In this issue of Arteriosclerosis, Thrombosis, and Vascular Biology , Awan and coworkers1 describe the study of 25 homozygous familial hypercholesterolemic (FH) patients aged 5 to 54 years. Eighteen of the patients had aortic calcification scores >1000. The inference of this study is a strong linkage between homozygous FH and premature aortic calcification. Bazan et al2 have recently described the age dependence of aortic calcification (Agatston units): 12.6±12.3 for <50 years, 14.6±8.2 for 50 to 59 years; 276±120 for 60 to 69 years, 1382±366 for 70 to 79 years, and 3889±778 for 80 years. Hence most of the elevated calcification observed in the Awan cohort is not attributable to age and may …