The paradox of asymptomatic carotid atherosclerosis in women: gender differences

Carotid atherosclerosis is a pathological condition associated with an increased risk of ischemic stroke, causing approximately 6 million deaths each year. Gender differences reveal that although men have a higher incidence of stroke than women, they exhibit lower rates of stroke-related death and disability. This discrepancy is likely due to women presenting more atypical symptoms, such as headaches, fatigue, and unexplained dizziness, leading to delayed hospital arrival and diagnosis. Early recognition and treatment aimed at preventing the progression of existing carotid atherosclerosis can significantly reduce complications. We present two clinical cases involving patients attending an angiological clinic: a female and a male patient with asymptomatic carotid stenosis, highlighting gender differences in risk factors and atherosclerotic plaque characteristics. We also emphasize how prevention and initiation of best medical therapy can bring significant benefits in life expectancy and complication reduction.