Anyway, given the pathophysiological complexity of CVD and the multiple factors involved, the optimal approach probably lies in the combined use of imaging techniques, the assessment of classical risk factors (e.g., conventional lipid profile, high blood pressure), polygenic scoring and tests aimed at detecting other alterations associated with early atherosclerosis (e.g., endothelial dysfunction, inflammatory markers [e.g., C-Reactive Protein, IL-1, IL-6, IL-18], proteomic or transcriptomic analyses and leptin and ghrelin dysregulations) (Figure 2). The gene discussed is IL18; the disease is endothelial dysfunction.