Most cardiovascular risk factors are things you accumulate. About one in five people worldwide carries enough of it to raise cardiovascular risk, and most of them have never been told. Among statin-treated participants, those with Lp(a) above 50 mg/dL showed elevated cardiovascular risk across every quartile of achieved LDL cholesterol. Lp(a) operates through pathways distinct from LDL cholesterol, and lowering one does not address the other. One point matters more than the averages: while concentrations vary across ethnic groups worldwide, the associated cardiovascular risk remains similar across populations.