This document summarizes research on the genetic influences and risk factors for carotid atherosclerosis and plaque development. Several genes have been identified as potentially associated with increased or decreased risk. Studies of twins and families suggest atherosclerosis has a strong genetic component, though environmental factors also play a role. The development of plaque appears to be influenced by an interaction between genetic and environmental risk factors. Ongoing research aims to better understand these genetic influences and interactions to help predict and prevent atherosclerotic disease.