Similar to the United States, women worldwide have lower stroke mortality than men except in the older age groups,62 65 and IS mortality has declined for both men and women, with some acceleration in the rate of decline in the 1990s for cer- tain age-sex groups.66 Ischemic Stroke An analysis of US death certificate data from 1995 to 1998 found that IS constitutes a larger percentage of stroke mor- tality overall in women than men (82% of stroke deaths in women versus 78% in men), with the greatest difference seen for older women.67 The overall age-adjusted IS death rate in women is slightly lower (74.3 per 100000 compared with 78.8 per 100000 for men; RR, 0.94; 95% confidence interval [CI], 0.93 0.95). Younger women have lower age-specific IS mor- tality than men, but there is a crossover at 65 years of age, at which point older women have higher age-specific IS mortal- ity than men.67 This study also reported that the age-adjusted death rate for IS was higher for white women than white men (RR, 1.21; 95% CI, 1.21 1.22), but for all other racial/ethnic groups, the age-adjusted death rate for IS was lower or similar for women and men.67 Hemorrhagic Stroke Women have higher age-adjusted SAH mortality than men Sex differences persisted across racial/ethnic groups and were highest among Asian Americans. In addition, the risk ratio of mortality in women versus men increased with In contrast to SAH, women have lower age-adjusted ICH mortality rates than men (13.3 per 100000 for women and 16.2 per 100000 for men; RR, 0.82; 95% CI, 0.81 0.83). 