Although the relationship between VSMC and NOTCH signaling during atherosclerosis is unclear, it has been found that atherosclerotic plaques in human carotid and femoral arteries usually have a lot of NOTCH3 proteins, and it is possible that Jagged1 stimulates the NOTCH signaling pathway in VSMCs, which causes pathological changes (57). This evidence concerns the gene NOTCH3 and atherosclerosis.