Gender- and Age-Based Differences in Nonsyndromic Arteriopathies in Younger Adults.

Aneurysms are often associated with connective tissue disorders, but most occur sporadically and are nonsyndromic. Manifestations of these nonsyndromic arteriopathies across genders and age groups have not been discussed extensively in previous studies, especially in younger cohorts. We analyzed data from 84,496 patients in the Mayo Clinic Tapestry DNA Sequencing Study, excluding those with known vascular syndromes. Patients aged ≤60years were included and grouped by gender and into 5 age groups (18 to 60 years). The odds and prevalence of various arteriopathies and complications (i.e., revascularization, stroke, dissection, and death) were compared. Overall, 909 patients aged ≤60 years were included, with 68.0% women (mean age 47.49 years). Women were more likely to have carotid/cerebral aneurysms (55.2% vs 31.6%, p <0.0001), and men were more likely to have thoracic (50.9% vs 21.8%, p <0.0001) and abdominal aortic aneurysms (7.22% vs 2.59%, p <0.01). Men with splanchnic and carotid/cerebral aneurysms were more likely to dissect (58.14% vs 21.49% and 45.65% vs 30.79%, p <0.05, respectively). Women were more likely to have multisite aneurysms (16.34% vs 12.03%, p <0.05), with the most common being concurrent carotid/cerebral and splanchnic aneurysms. Both genders showed peak dissection rates at ages 36 to 45 years, although men experienced more complications in older age groups (56 to 60 years) and women in younger ones (46 to 55 years). In conclusion, men are more susceptible to large vessel aneurysms and complications later in life, whereas women more frequently experience medium-vessel aneurysms, complications earlier in life, and co-occurring multisite aneurysms. Potential unidentified genetic factors could be influencing these patterns.