This study reports on the burden of stroke in women across different ethnic groups from 1981 to 2003, using data from three population-based registers identifying all first-ever and recurrent strokes in residents (aged ≥15 years) of Auckland, New Zealand, in the 12-month periods from 1981–1982, 1991–1992, and 2002–2003. The WHO standard world population was used for direct age standardisation of annual rates (per 100,000 population). While the proportion of women who have experienced a stroke did not change noticeably over the study period, ethnic differences emerged which were related to population changes within the New Zealand population. Standardised stroke incidence in women was relatively stable across the three study periods (1981–1982), 133; (1991–1992), 143; and (2002–2003), 124. However, rates of first-ever stroke in women declined significantly by 14% between 1991–1992 and 2002–2003. In contrast to the significant declines in event rates in European women over two decades (Rate ratio 0.84), Pacific women experienced increasing trends in event rates (2.71). The rate of stroke for Mäori women did not change significantly over time. Over half of the women who had a stroke event reported that they had high blood pressure; 25% reported that they had diabetes. The proportion of women who smoked declined over time but increases in body mass index indicated weight gains in women over time. These trends were consistent across ethnic groups. Women’s survival after 1 month following their stroke has improved by 39% over the 20-year period. Favourable changes in early survival were most pronounced in European women.
