Fig. 4: Sex disparities in atherosclerosis onset and plaque progression.

a Sex differences in plaque burden characteristics (n = 16,300). (The 1st row) Scatter plots and kernel density estimates of ‘raw’ plaque PAV values for total plaque, calcified, fibrous, fibro-fatty, and lipid plaques. (The 2nd row) Box plots of plaque PAV distributions by age group. Solid lines mark means, dashed lines mark medians, boxes show interquartile ranges (25th–75th percentiles), and whiskers extend to 1.5 × IQR. (The 3rd row) Mean PAV-age trajectories (solid lines) and 10% and 90% centiles (dotted lines). (The 4th row) Rates of PAV change over the lifespan, derived from PAV-age trajectories. All plots are stratified by sex (female, red; male, blue). b Sex differences in plaque morphologies. Violin plots with means for maximum stenosis ratio, eccentricity index, and remodeling index, and prevalence of obstructive stenosis and high-risk plaque, which are calculated as the number of positive subjects divided by the group size. c Disparities in atherosclerosis severity between sexes. The delayed onset of CCTA-detected atherosclerosis in women was modeled by shifting the x-axis relative to men in 1-year interval and identifying the minimum of the sum of squared differences in annualized atherosclerosis prevalence between sexes. (Left) Yearly trajectories of mean total plaque PAV (solid lines) and prevalence of obstructive stenosis (dashed lines with circular markers); (right) sum of squared differences in atherosclerosis severity between women and men across different age shifts.