Stroke is the third leading cause of death among women in the United States, affecting 55,000 more women than men each year.

Investigators from Brigham and Women's Hospital and their colleagues are exploring the effects of potential risk factors that are unique to women, including hormone levels, hormone therapy, hormonal birth control, pregnancy and time of menarche and menopause.

"Many people don't realize that women suffer stroke more frequently than men, and mortality is much higher among women. As women age, they are much more likely to have a stroke as the first manifestation of cardiovascular disease rather than a heart attack," said corresponding author Kathryn Rexrode, MD, MPH, of the BWH Department of Medicine. "We want to better understand susceptibility: why do more women have strokes than men? What factors are contributing and disproportionately increasing women's risk?"

Factors elevating stroke risk among women include early age menarch, less than 10-years-old, early age menopause, less than 45 years old, low levels of hormone dehydroepianrosterone, low levels of hormone dehydroepiandrosterone (DHEAS), and taking oral estrogen or combined oral contraceptives.

"These women should be monitored carefully and they should be aware that they are at higher risk, and motivated to adhere to the healthiest lifestyle behaviors to decrease the risk of hypertension and subsequent stroke," Rexrode said.