The lipoprotein lipase gene is highly polymorphic, and several common mutations have been associated with an increased atherogenic lipid profile. One of these, Asn291Ser, was also found to be associated with increased ischemic heart disease in women. More recently, this same mutation, present in approximately 5% of the population, was also associated with increased ischemic cerebrovascular disease risk. The magnitude of this increase is less than or equal to that attributed to other modifiable risk factors, such as hypertension, smoking, and hypercholesterolemia. A prudent diet and lifestyle should therefore attenuate the higher genetic predisposition to atherosclerosis observed in women carrying this mutation.