Introduction:Stroke is a leading cause of long-term disability and mortality worldwide, particularly in developing countries. Dyslipidemia, especially the triglyceride to high-density lipoprotein ratio (TG/HDL), and body mass index (BMI) play important roles in cardiovascular disease pathogenesis, including ischemic stroke. Methods:This analytical observational study used a cross-sectional design based on medical records of ischemic stroke patients at RSUD Kabupaten Tangerang in 2025. A total of 50 patients were selected from 98 using purposive sampling. Variables included BMI, TG/HDL ratio, age, sex, hypertension, and diabetes mellitus. The data were analyzed using Chi-Square, Fisher's Exact tests, and risk estimate. Results:The mean age was 61.60±9.05 years. Most patients were male, with a high prevalence of hypertension and diabetes mellitus. A total of 68% were overweight/obese and 78% had high TG/HDL ratio. A significant association was found (p=0.011; Fisher's Exact p=0.024) with OR 5.833 (95% CI: 1.387–24.539). Discussion:The predominance of elderly patients with vascular comorbidities highlights the role of degenerative and metabolic factors in ischemic stroke. A higher TG/HDL ratio in overweight/obese patients reflects an atherogenic lipid profile associated with increased BMI. This condition, mediated by visceral fat accumulation, insulin resistance, and chronic inflammation, contributes to atherosclerosis underlying ischemic stroke.
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