New Research Uncovers Gender Variations in Carotid Artery Plaques and Stroke Symptoms

Recent findings published in Nature Cardiovascular Research highlight significant gender-based differences in carotid artery plaques and the associated symptoms of stroke. The study reveals that while both males and females experience carotid artery narrowing, the characteristics of plaques and symptoms differ notably between the sexes. The research indicates that, although the predominant cell types within the plaques are similar, there are critical variations in the smaller structures found within those cells.

Cardiovascular diseases remain a leading cause of mortality globally, with approximately 17.9 million deaths annually, according to the World Health Organization. Among these, heart attacks and strokes account for 85% of fatalities. The study emphasizes that biological sex influences carotid stenosis, the narrowing of the carotid artery, the development of atherosclerosis, and overall cardiovascular risk, with age and menopause further complicating these factors.

Research indicates that men typically face a higher risk of developing cardiovascular diseases at an earlier age, often presenting with lipid-rich plaques and bleeding. Conversely, women, possibly benefiting from the protective effects of pre-menopausal hormones, tend to develop carotid stenosis later, exhibiting more plaque erosion. Understanding these gender-specific differences is crucial for improving treatment and prevention strategies.

The research utilized single-cell RNA sequencing to examine the cellular makeup of carotid plaques collected from patients undergoing surgery to remove blockages in the neck arteries. Advanced bioinformatics analysis revealed significant gender-biased differences in the subcellular composition of these plaques, despite only minor variations in the major cell types such as smooth muscle cells, macrophages, and endothelial cells.

Findings showed that females exhibited a higher presence of osteogenic smooth muscle cells, macrophages involved in immune regulation, and endothelial cells transitioning into mesenchymal cells. In contrast, males had a greater number of chondrocyte-like smooth muscle cells, macrophages associated with tissue remodeling, and angiogenic endothelial cells that stimulate new blood vessel formation.

The study, which explores the sex-specific molecular mechanisms and gene regulatory networks in atherosclerotic plaques, aims to identify potential therapeutic targets tailored to each gender. The authors stress the importance of considering biological sex as a key variable in the study of atherosclerosis to enhance risk prediction, ensure accurate diagnoses, and facilitate personalized and effective treatment strategies for both men and women.

For further information, the full study can be accessed in Nature Cardiovascular Research.