This document discusses the genetic influences and mechanisms involved in the development of carotid atherosclerosis and carotid artery plaque. Some key points: - Atherosclerosis has both environmental and strong genetic components. Studies in twins show genetics plays a major role. - Over 400 genes are involved in regulating atherosclerotic plaque formation and other processes like inflammation and metabolism. However, the roles of most genes are still unknown. - Several studies have found associations between certain gene polymorphisms like connexin 37, ACE, NPY, and IL-6, and increased carotid intima-media thickness and plaque formation. - The presence of carotid plaque shows heritability and a common genetic basis with other cardiovascular