title: Is Carotid Stenosis in Women a Gender-Related Condition?
abstract: BACKGROUND
  We set out to study, through ultrasound examinations, the carotid bifurcation in men and women with/without carotid stenosis to look for anatomical and electrophysiologic differences. We evaluated other variables to look for differences that might explain the dissimilar behavior of this disease in the two sexes and the presence and impact of risk factors.
  
  
  METHODS
  We examined 974 subjects aged 25 to 88 years (478 men and 496 women) in whom we considered heart rate, smoking status, and the presence of hypertension, diabetes, hypercholesterolemia, and hypertriglyceridemia. Ultrasound examination of the neck vessels included measurement of intimal medial thickness (IMT), vessel diameter, and outflow area/inflow area ratio. We established plaque location, echogenicity and echostructure, and the percentage of stenosis owing to plaque and measured systolic velocity, flow direction, and the depth of detection of these parameters. We used the apnea and hyperpnea test to assess cerebrovascular reactivity.
  
  
  RESULTS
  Hypertension and hypercholesterolemia were the most frequent risk factors. Women had a higher heart rate, whereas men had significantly greater IMT. The presence of atheromatous plaque was significantly correlated with age in both sexes, with men having a higher prevalence of carotid plaques. The sexes differed significantly with regard to plaque location, echogenicity, echostructure, and intracranial circulation. Women had a slightly higher blood flow velocity in the intracranial arteries. Risk factors affected plaque formation and extent more in men than in women.
  
  
  CONCLUSIONS
  These findings suggest that carotid stenosis is a gender-related trait.
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Luciana
authors.initials: L
authors.lastname: Tromba
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Francesco
authors.initials: F
authors.lastname: Tartaglia
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Sara
authors.initials: S
authors.lastname: Blasi
authors.affiliation: 2 Superior Institute of Health , Rome, Italy .
authors.forename: Alessandro
authors.initials: A
authors.lastname: Giuliani
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Sabino
authors.initials: S
authors.lastname: Carbotta
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Demetra
authors.initials: D
authors.lastname: Kiltzanidi
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Stefania
authors.initials: S
authors.lastname: Cavaiola
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tortorelli
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Giovanni
authors.initials: G
authors.lastname: Carbotta
authors.affiliation: 1 Surgical Sciences Department, Sapienza University of Rome , Rome, Italy .
authors.forename: Fabio
authors.initials: F
authors.lastname: Pelle
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000503:physiopathology; D015228:Hypertriglyceridemia / Q000453:epidemiology; D007558:Italy; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D017539:Tunica Intima / Q000473:pathology*