BACKGROUND: Common genetic variants in the PCSK9 gene have been reported to be associated with both elevated and exceptionally low LDL levels. The association of a common haplotype, encompassing the E670G single nucleotide polymorphism, with LDL levels reported by Chen et al (J Am Coll Cardiol 2005; 45: 1644) was not confirmed by Kotowski et al (Am J Hum Genet 2006; 78:410-422). METHODS: The incidence of the E670G SNP was determined in 506 patients attending the lipid clinic, University Hospital, Hamburg. RESULTS: The frequency in men with polygenic hypercholesterolemia, 0.11 was significantly higher than in men with LDL