Global trend and disparity in the burden of ischemic stroke attributable to high body-mass index from 1990 to 2021 and projection to 2050: a systematic analysis based on the Global Burden of Disease Study 2021

Purpose: This study assessed the global burden, trends, and socioeconomic disparities of ischemic stroke attributable to high body-mass index (IS-HBMI) from 1990 to 2021, and to project future trends to 2050. Methods: Data were extracted from the Global Burden of Disease Study 2021 (GBD 2021; data accessed on [November 8, 2025]). The analysis focused on ischemic stroke attributable to high body-mass index, measuring deaths, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASMR and ASDR) across all ages, both sexes, and all Socio-demographic Index (SDI) regions. Temporal trends were analyzed using Joinpoint regression (estimated annual percentage change, EAPC), and drivers of mortality change were quantified via demographic decomposition. A Bayesian age-period-cohort (BAPC) model projected future burden to 2050. Regional performance was benchmarked using a best-performance frontier analysis. Conclusion: The study revealed that the global disease burden of IS-HBMI had continuously increased from 1990 to 2021, and it was predicted to escalate until 2050. The findings emphasize the need for more detailed IS screening and weight loss measures tailored to specific regions and populations, which would benefit efforts to curb the projected rise in IS-HBMI deaths.