In the presence of cardiometabolic risk factors (i.e., hypertension, obesity, prediabetes, and hypercholesterolemia) occurs endothelial cell activation, which is characterized by the expression of cell surfaces adhesion molecule, such as vascular cell adhesion protein 1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and E-selectin. The gene discussed is VCAM1; the disease is familial hypercholesterolemia.