To analyze the current status and changing trends of ischemic stroke burden attributable to high LDL-C in China from 1990 to 2021. By integrating the prediction results for the next decade, this research offers actionable insights for designing evidence-based interventions targeting ischemic stroke prevention and management in China.

Data were obtained from the Global Burden of Disease Study (GBD) 2021 database and screened for Chinese regions, causes of ischemic stroke deaths, and high LDL-C risk factors. The disease burden was measured using indicators such as mortality and disability-adjusted life year (DALY) rates, and systematically analyzed the trends using the Joinpoint regression model. The autoregressive moving average (ARIMA) model was employed to predict the standardized mortality and standardized DALY rates of ischemic stroke attributable to high LDL-C in China from 2022 to 2031.

The overall trend of ischemic stroke rates attributable to high LDL-C in the Chinese population was declining between 1990 and 2021, with mean annual percentage changes (AAPC) of-0.42% (95% CI: -0.66%~-0.18%, P<0.05) and -0.46% (95% CI: -0.63%~-0.29%, P<0.05), with significant age and sex disparities observed. According to the ARIMA model, China’s standardized mortality and DALY rates linked to elevated LDL-C would decline to 15.01 per 100 000 population and 319.00 per 100 000 population, respectively, by 2031.

The disease burden of ischemic stroke attributable to high LDL-C remains substantial in China, and the interventions on LDL-C levels in the priority populations of men and elderly ischemic stroke patients should be reinforced, and prevention and control strategies as well as institutional support should be improved for the purpose of alleviating the disease burden of ischemic stroke more effectively.