A 52-year-old man with a family history of premature coronary artery disease presents with xanthomas and corneal arcus. Lipid panel shows total cholesterol 480 mg/dL, LDL 420 mg/dL, HDL 35 mg/dL, and triglycerides 150 mg/dL. Genetic testing confirms heterozygous familial hypercholesterolemia (FH). Regarding the pathophysiology and management of FH, all of the following are true EXCEPT:

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