Certain genetic variants, such as the phosphodiesterase 4D gene, are specifically associated with higher cIMT levels in males, but not in females.48 Interestingly, the phosphodiesterase 4 isoenzyme family is widely expressed within the central nervous system, and the disruption of its activities is associated with mood and memory disturbances.49 Thus, a conjectural explanation would be that males with such genetic variants would be susceptible to both ESs and atherosclerosis. Here, PDE4D is linked to atherosclerosis.