Abstract
There is convincing evidence for sex differences in carotid atherosclerosis although the relation between sex and plaque characteristics needs further insight accessing individual patient data characteristics to perform these analyses. The structure and composition of arterial walls can differ between genders. At every age, most women are of shorter stature and smaller size than most men. Height is related directly to arterial caliber and length as well as cardiac output through effects on stroke volume and heart rate.Statistical comparisons for gender suggest that females appeared more vulnerable to the progression of arterial stiffening [1]. Carotid plaque measurements using maximum wall thickness as 1-dimensional (1D) size, wall area as 2D size, and wall volume as 3D size are larger in men opposed to women [2]. Nevertheless, the normalized wall index, which accounts for the total vessel size, shows no significant difference between males and females. Regarding the number of calcifications, it was found that men have higher calcification volumes than women and accordingly intraplaque hemorrhage is more common in men than in women [3]. Sex differences in stroke incidence, and complication rate have been reported [4].The current study aims a review of recent publications on gender-specific differences regarding carotid plaque characteristics and stroke risk aiming different biomarkers for men and women what may benefit clinical management and specific treatment.[1] Wang Z, Li W, Liu W, Tian J. Gender is a determinant of carotid artery stiffness independent of age and blood pressure. Br J Radiol. 2021 Mar 1;94(1119):20200796. [2] van Dam-Nolen DHK, van Egmond NCM, Dilba K, Nies K, van der Kolk AG, Liem MI, Kooi ME, Hendrikse J, Nederkoorn PJ, Koudstaal PJ, et al. Sex differences in plaque composition and morphology among symptomatic patients with mild-to-moderate carotid artery stenosis. Stroke. 2022; 53:370378. [3] Scheffler M, Pellaton A, Boto J, Barnaure I, Delattre BM, Remuinan J, Sztajzel R, Lovblad KO, Vargas MI. Hemorrhagic plaques in mild carotid stenosis: the risk of stroke. Can J Neurol Sci. 2021; 48:218225. [4] Voigt S, van Os H, van Walderveen M, van der Schaaf IC, Kappelle LJ, Broersen A, Velthuis BK, de Jong PA, Kockelkoren R, Kruyt ND, et al; DUST study group. Sex differences in intracranial and extracranial atherosclerosis in patients with acute ischemic stroke. Int J Stroke. 2021;16: 385391.
Published Version
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