Abstract Background and aims This study evaluated the prevalence, incidence, mortality, and disability burden of ischemic stroke (IS) in Nepal from 1990 to 2023 to inform effective policy development and healthcare planning. Methods Data were obtained and analyzed from the 2023 Global Burden of Disease (GBD) estimates. Age-standardized rates (ASR) and counts of prevalence, incidence, deaths, and DALYs were analyzed from 1990 to 2023. Temporal trends in age-standardized rates were quantified using estimated annual percentage changes (EAPCs) derived from a log-linear regression model. Results The number of prevalent cases increased significantly from 72,602 in 1990 to 202,923 in 2023, with the ASR increasing from 695.69 to 755.16 per 100,000 population (EAPC 0.32%). Incident cases nearly tripled from 7,571 to 22,515, and the ASR increased from 81.78 to 90.57 per 100,000 population (EAPC 0.47%). DALYs rose from 70,360 to 161,101, while the ASR declined from 853.30 to 661.67 per 100,000 population (EAPC –0.97%). Deaths increased from 2,896 to 7,191, but the ASR fell from 44.97 to 33.29 per 100,000 population (EAPC –1.11%). Sex-disaggregated data revealed that females experienced sharper declines in mortality (EAPC –1.83%) and DALYs (EAPC –1.71%) compared to males (–0.34% and –0.26%, respectively). Conversely, males showed a steeper increase in incidence (EAPC 0.59%) compared to females (EAPC 0.36%). The burden of disability remained heavily concentrated in the elderly. Conclusions While the decline in IS mortality and DALY rates in Nepal reflects improvements in acute care and secondary prevention, the increase in prevalance and incidence over the past three decades points toward rapid epidemiological shift. Conflict of interest Gaurav Nepal, Rajeev Ojha: nothing to disclose
Nepal et al. (2026) studied this question.