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Gender differences in blood velocities across carotid stenoses
Anthony J Comerota1, Sergio X Salles-Cunha, Yahya Daoud
1Jobst Vascular Center, Toledo, OH 43606, USA. mgravett@jvc.org
Journal of Vascular Surgery
|November 24, 2004
Summary
Women exhibit higher carotid blood flow velocities than men. These gender differences in peak systolic velocity and end-diastolic velocity are significant at key thresholds, suggesting tailored diagnostic criteria for carotid artery disease are needed.
Area of Science:
- Vascular Ultrasound
- Cardiovascular Imaging
- Medical Diagnostics
Background:
- Carotid duplex scanning is standard for diagnosing carotid artery disease.
- Carotid endarterectomy (CEA) reduces stroke risk in select patients.
- Existing data suggest potential gender-based differences in CEA efficacy.
Purpose of the Study:
- To investigate gender differences in carotid blood flow velocity at similar arteriographic stenoses.
- To determine if these differences are significant at clinically relevant stenosis thresholds.
Main Methods:
- Prospective database of 938 carotid arteriograms with peak systolic velocity (PSV) and end-diastolic velocity (EDV) measurements.
- Stenosis calculated per North American Symptomatic Carotid Endarterectomy Trial criteria.
- Comparison of velocities between men and women across 10% stenosis intervals using Student t-test.
Main Results:
- Women showed higher average PSV (9%) and EDV (6%) than men across all intervals.
- Significant gender differences in PSV and EDV were observed at 60% and 70% stenosis (P=.03).
- Optimal PSV criteria for 70% stenosis differed: 185 cm/s for men and 202 cm/s for women.
Conclusions:
- Women possess higher carotid blood flow velocities compared to men.
- These gender-specific velocity differences are pronounced at thresholds relevant for intervention.
- Current interpretation criteria for carotid duplex ultrasound may require gender-specific adjustments for optimal patient care.