Advancing the study of stroke in women: summary and recommendations for future research from an NINDS-Sponsored Multidisciplinary Working Group.
OBJECTIVE
Women have poorer outcomes from stroke than men. Women also have risk factors that are unique, including pregnancy and hormone therapy. Hormone therapy for postmenopausal replacement increased the risk of ischemic stroke according to results of the Women's Health Initiative clinical trials. Based on the current understanding of the mechanisms of action of estrogen, the reasons for this increased risk are uncertain. One method to better understand the reasons for this increased risk is to re-evaluate estrogen's role in the neurovascular unit, simplistically comprised of the neurons, glia, and endothelial cells, as well as the processes of inflammation, and hemostasis/thrombosis. Besides the role of estrogen there are many gaps of knowledge about issues specific to women and stroke.


RESULTS
A multidisciplinary workshop was held in August 2005 to summarize the current evidence for estrogen and, more generally, stroke in women, and to provide recommendations for future basic, preclinical, and clinical research studies.


CONCLUSIONS
These studies may ultimately change the approach to stroke prevention and treatment in women.
Bushnell
Cheryl D
CD
Department of Medicine, Division of Neurology, Duke University Medical Center, Durham, NC 27710, USA. Cheryl.bushnell@duke.edu
Hurn
Patricia
P
Colton
Carol
C
Miller
Virginia M
VM
del Zoppo
Gregory
G
Elkind
Mitchell S V
MS
Stern
Barney
B
Herrington
David
D
Ford-Lynch
Gwendolyn
G
Gorelick
Philip
P
James
Andra
A
Brown
Candice M
CM
Choi
Emily
E
Bray
Paul
P
Newby
L Kristin
LK
Goldstein
Larry B
LB
Simpkins
James
J
D005260:Female; D006801:Humans; D012727:Sex Characteristics; D020521:Stroke / Q000209:etiology*; D016387:Women's Health