Stroke patients across Africa and Asia carry a heavy and often unrecognized burden of dyslipidemia, according to a systematic review and meta-analysis published in BMC Cardiovascular Disorders. Pooling data from 28 observational studies covering 6,033 stroke patients, the analysis found that 48.11% of patients had decreased high-density lipoprotein cholesterol, the so-called good cholesterol, with a 95% confidence interval of 37.21% to 59.00%. Elevated low-density lipoprotein cholesterol was present in 37.48% of patients (95% CI: 28.72% to 46.25%), while hypercholesterolemia affected 33.62% (95% CI: 27.48% to 39.76%) and hypertriglyceridemia affected 28.04% (95% CI: 19.31% to 36.76%). The authors, led by Afewerk Habtamu, conclude that dyslipidemia is highly prevalent among stroke patients in these two regions and that the findings support routine lipid-profile assessment and appropriate lipid-lowering interventions as components of stroke prevention and secondary prevention strategies.
The review addressed a gap that the authors describe as longstanding: although stroke remains one of the leading causes of death and disability worldwide and dyslipidemia is one of the major modifiable cardiovascular risk factors, the burden of lipid abnormalities among stroke patients in Africa and Asia had never been comprehensively summarized. To fill that gap, the research team searched PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, CINAHL and the Cochrane Library from inception to September 8, 2026, supplementing the database searches with reference-list screening and grey-literature searches. Eligible studies were observational designs reporting the prevalence of at least one predefined lipid abnormality among stroke patients in Africa or Asia. Because the underlying studies varied widely in design and population, the authors pooled prevalence estimates using a random-effects DerSimonian-Laird model, an approach that does not assume a single true prevalence across studies but instead models between-study variation explicitly.
That variation was substantial. For every lipid outcome, the I² statistic, which quantifies the proportion of variability in effect estimates attributable to heterogeneity rather than chance, ranged from approximately 95% to 99%, and Cochran’s Q test was used to assess statistical heterogeneity alongside it. In practical terms, this means the pooled percentages describe a central tendency across markedly different study settings rather than a uniform prevalence that clinicians should expect everywhere. Subgroup analyses were therefore conducted according to geographic region, stroke type, study design, comorbidity, and study period. These analyses indicated significant differences by study design for hypercholesterolemia and increased LDL-C, whereas differences according to stroke type, comorbidity, and study period were generally not statistically significant.
The authors also took deliberate steps to check that the pooled estimates were not artifacts of any single study or of selective reporting. Leave-one-out sensitivity analyses, in which each study is removed in turn and the meta-analysis is recalculated, showed that removal of any individual study did not materially alter the pooled estimates, a sign that the findings are not being driven by one influential dataset. Publication bias was assessed using Egger’s and Begg’s tests as well as the Doi plot with the Luis Furuya-Kanamori index, methods designed to detect whether smaller studies with particular results are overrepresented in the published literature. Study quality was assessed using the Joanna Briggs Institute checklist for cross-sectional studies and the Newcastle-Ottawa Scale for cohort studies, providing a structured appraisal of the risk of bias in the included research.
Several features of the evidence base deserve emphasis when interpreting the numbers. The included studies were observational, meaning they measured the prevalence of lipid abnormalities among stroke patients rather than testing whether treating those abnormalities changes outcomes; the meta-analysis therefore estimates burden, not treatment efficacy. The wide confidence intervals, particularly for hypertriglyceridemia, whose interval spans more than 17 percentage points, reflect both the moderate number of included studies and the very high heterogeneity. The subgroup finding that study design mattered for hypercholesterolemia and increased LDL-C suggests that how a study was conducted influenced its measured prevalence, which readers should weigh when considering the pooled figures as regional benchmarks.
Geographic scope is another consideration. The analysis combined studies from Africa and Asia, and while subgroup analyses by geographic region were planned, the reported headline estimates apply to the combined population of 6,033 patients from both continents. The authors note that differences according to stroke type, comorbidity, and study period were generally not statistically significant, which limits the ability to draw fine-grained conclusions about which patient subgroups carry the greatest lipid burden. The review was published as open access on November 4, 2026, and the publisher notes that the shared version is citable and carries a permanent DOI, subject to further edits before the final Version of Record.
For clinicians and public health planners in the covered regions, the practical takeaway is that lipid abnormalities are common enough among stroke patients that systematic screening is likely to identify a substantial fraction of affected individuals. The authors’ conclusion that these findings support routine lipid-profile assessment and appropriate lipid-lowering interventions is framed as part of comprehensive stroke prevention and secondary prevention strategies, not as a mandate for any specific drug regimen. Because the analysis is a synthesis of observational prevalence data, decisions about individual patient management would still rest on clinical guidelines and direct assessment of each patient’s lipid profile and overall vascular risk.
Subject of Research: Pooled prevalence of dyslipidemia among stroke patients in Africa and Asia
Article Title: Lipid abnormalities among stroke patients in Africa and Asia: a systematic review and meta-analysis
Article References: Habtamu, A., Getnet, E., Belayhun, E., Feyisa, M. S., Tefera, M. W., Tilahun, M., Achame, M. S., Arage, R. B., Sebsibe, S., Desale, S., Kassa, S., Asmare, Y., Erkihun, Y., Mulatie, Z., & Eshetu, B. (2026). Lipid abnormalities among stroke patients in Africa and Asia: a systematic review and meta-analysis. BMC Cardiovascular Disorders. https://doi.org/10.1186/s12872-026-06976-2
Image Credits: AI Generated
DOI: 10.1186/s12872-026-06976-2
Keywords: stroke, dyslipidemia, hypercholesterolemia, hypertriglyceridemia, LDL cholesterol, HDL cholesterol, meta-analysis, systematic review, Africa, Asia, cardiovascular risk factors, secondary prevention
Tags: AfricaAsiaCardiovascular risk factorsdyslipidemiaHDL cholesterolhypercholesterolemiahypertriglyceridemiaLDL cholesterolMeta-analysissecondary preventionStrokesystematic review
