Distribution of Estimated 5-year Stroke Risk Using the Stroke Riskometer™ Among Adults in Kathmandu, Nepal: A Cross-sectional Study

Introduction: Stroke is a leading cause of death and disability globally, while Nepal is experiencing a growing burden of non-communicable disease. Community-level data on estimated individual stroke risk remain limited. This study characterized estimated 5-year stroke risk among adults in Kathmandu Metropolitan City using the Stroke Riskometer™. Methods: A community-based cross-sectional study included 422 adults aged ≥20 years. Five wards were purposively selected, followed by random household sampling and Kish-grid respondent selection within wards. Fiveyear absolute stroke risk was estimated using the Stroke Riskometer™. Risk distributions were summarized using medians and interquartile ranges (IQR), with subgroup distributions presented descriptively. Results: Median estimated 5-year stroke risk was 2.50% (IQR 1.40 –5.80%), ranging from 0.60% to 48.30%. Using study-defined descriptive thresholds, 261 (61.85%) participants had estimated risk ≥2.0%; these thresholds are not validated clinical categories. Median estimated risk increased from 1.40% among participants aged 20–39 years to 8.80% among those aged ≥60 years. Excluding 11 participants with previous TIA/stroke yielded a median risk of 2.40% (IQR 1.40 –5.60%). Conclusions: Estimated 5-year stroke risk showed a wide, right-skewed distribution in this community sample. Prospective validation against incident stroke outcomes is required before clinical or public-health application in Nepal.