In this episode, Editor-in-Chief Marcelo F. Di Carli, MD, MASNC, is joined by Daniel S. Berman, MD, MASNC and Donghee Han, MD, from the Cedars Sinai Medical Center, to discuss their manuscript ‘Independent prognostic significance of myocardial flow reserve over coronary artery calcium, myocardial perfusion, and clinical variables in patients without known coronary artery disease, according to diabetes status’ and explore the intersection of vascular health, cardiometabolic disease, atherosclerosis and advanced cardiovascular imaging. They examine new evidence about the challenges that traditional boundaries between metabolic health and vascular risk pose to our field.