Genetics of Carotid Atherosclerosis

Many issues related to carotid atherosclerotic disease and stroke remain unresolved despite the recognition of risk factors and the development of effective stroke prevention strategies. Who is at greatest risk of developing carotid atherosclerosis? Among those with carotid atherosclerosis, who is at highest risk to have a stroke? Who is likely to benefit from carotid revascularization? Should endarterectomy or stenting be used for revascularization? Who should be managed with intensive medical therapy without revascularization? Are there predictors of response to these medical therapies? What is the relationship between carotid atherosclerotic disease and cognitive functioning and does revascularization alter that relationship? Genetic investigation has the potential to help answer these questions and recent genetic advances are leading to a better understanding of carotid disease and its response to therapy. This chapter will focus on carotid atherosclerotic disease and its relationship to ischemic stroke. Other chapters in this volume will address other forms of carotid pathology related to stroke, such as carotid dissection.