Lipid abnormalities among stroke patients in Africa and Asia: a systematic review and meta-analysis

Stroke remains one of the leading causes of death and disability worldwide and dyslipidemia is one of the major modifiable cardiovascular risk factors. However, the burden of lipid abnormalities among stroke patients in Africa and Asia has never been comprehensively summarized. Therefore, this systematic review and meta-analysis was conducted to estimate the pooled prevalence of dyslipidemia among stroke patients in Africa and Asia. PubMed/MEDLINE, Embase, Scopus, Web of Science, Google Scholar, CINAHL and Cochrane Library were searched from inception to September 08, 2026, supplemented by reference-list screening and grey-literature searches. Observational studies reporting the prevalence of at least one predefined lipid abnormality among stroke patients in Africa or Asia were eligible. Study quality was assessed using the Joanna Briggs Institute checklist for cross-sectional studies and the Newcastle–Ottawa Scale for cohort studies. Pooled prevalence estimates with 95% confidence intervals (CIs) were calculated using a random-effects DerSimonian-Laird model. Statistical heterogeneity was assessed using I² and Cochran’s Q test. Subgroup analyses were conducted according to geographic region, stroke type, study design, comorbidity, and study period. Leave-one-out sensitivity analyses were performed to examine the influence of individual studies, while publication bias was assessed using Egger’s and Begg’s tests and the Doi plot with the Luis Furuya-Kanamori index. Twenty-eight studies involving 6,033 stroke patients from Africa and Asia were included. The pooled prevalence of hypercholesterolemia was 33.62% (95% CI: 27.48% – 39.76%), hypertriglyceridemia was 28.04% (95% CI: 19.31% – 36.76%), elevated LDL-C was 37.48% (95% CI: 28.72% – 46.25%), and decreased HDL-C was 48.11% (95% CI: 37.21% – 59.00%). Substantial heterogeneity was observed for all outcomes, with I² values ranging from approximately 95% to 99%. Subgroup 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. Leave-one-out analyses showed that removal of any individual study did not materially alter the pooled estimates. Dyslipidemia is highly prevalent among stroke patients in Africa and Asia. These findings support routine lipid-profile assessment and appropriate lipid-lowering interventions as components of comprehensive stroke prevention and secondary prevention strategies in these regions.