Comparative study on age-related changes and atherosclerotic involvement of the coronary arteries of male and female subjects up to 40 years of age.

In an unselected population sample of Bucharest, including 536 subjects (284 males and 252 females) aged up to 40 years, sex appeared as one of the most important factors influencing the pattern of coronary artery growth and remodelling, as well as the pattern of atherosclerotic involvement. The internal elastic membrane of the female coronary arteries of neonates, children, juveniles and adolescents manifested a lesser tendency to fragment, to interrupt and to exhibit elastolysis than did the corresponding internal elastic membrane of male subjects. In the anterior descending and circumflex arteries, female subjects had less intima than males of similar age. Women developed the first atherosclerotic plaques a decade later than men and at a similar age showed fewer atherosclerotic plaques and atheromas. These sex differences were statistically significant for the anterior descending and circumflex arteries, but not for the right coronary artery. During adulthood, the number of women with a three vessel involvement was half that of men. In successive age groups, the degree of luminal narrowing by atherosclerotic plaques was constantly and consistently lower in female than in male subjects.