International Circulation: Increased blood pressure， lipids and glucose are the three common risk factors for cardiovascular diseases. What are the differences between them?
《国际循环》：血压、血脂、血糖升高是心血管疾病最重要的三大危险因素，他们危害有何不同？

Prof Nilsson: We need to mention smoking too I think. First of all smoking because now we are in China， I have seen the figures stating that 65% of the main population is smoking， especially males. So before we talk about anything else， let’s address smoking – the number one killer. The interesting thing about smoking is that it is not only harmful in itself， it is also a marker for many other things: a poor diet， less physical activity， etc.， and also for the dangers of early life programming. Smoking in pregnancy is very harmful to the growing fetus and could also influence future cardiovascular health so smoking in men and women might have a great impact on future cardiovascular risk， much more than we used to think. As well， there are a lot of metabolic risk factors and risk markers for which we need evidence from intervention trials to classify as such. That is the difference between LDL cholesterol on the one hand and triglycerides on the other hand， because triglycerides are well known to be risk markers but not risk factors in the same sense. Of course these things often go together. We talk about the metabolic syndrome and abdominal obesity - this is a growing problem when we see elevated glucose levels， dyslipidemia and elevated blood pressure. The metabolic syndrome has been a concept that has been discussed for twenty years or so， however the essence of the metabolic syndrome is what I call the EVA syndrome- Early Vascular Aging. The risk factor burden will impact on the arterial wall and we see an early aging phenomenon. We can have a patient with a chronological age of 50， however the arteries are 60 years old. Why? Because of the risk factor burden – a less healthy diet， genetic factors too， even fetal programming can play a role. The beauty of this concept is that you can start a dialogue with your patients and tell them that their arteries are much older than they are themselves， so please do something about it. What should I do? Improvement of lifestyle and eventually some drug therapy. So in my mind， metabolic syndrome equates to the EVA syndrome.