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Tortuosity of the carotid arteries can be caused by several factors, including aging, atherosclerosis, and genetic predisposition. As individuals age, the arterial walls may lose elasticity, leading to increased bending and twisting. Additionally, atherosclerotic changes can contribute to the structural alterations of the arteries, resulting in tortuosity. Other potential factors include hypertension and lifestyle choices, such as smoking and poor diet, which can exacerbate arterial changes.

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