Carotid plaque and intima media thickness does not differ between statin-treated heterozygous FH patients and controls. This suggests a normalization of atherosclerotic cardiovascular disease (ASCVD) risk in statin-treated FH. Carotid IMT is not associated with coronary calcification in heterozygous FH patients. Carotid plaques are associated with coronary calcification in heterozygous FH patients. These findings suggest that sonography of carotid arteries during follow-up of statin-treated FH patients has limited value.