This analysis of risk factors in Nepal projected noncommunicable diseases will contribute to over two-thirds of total deaths in 2040, a significant increase from 1990. A tenth of the total deaths in Nepal in 1990 was attributed to five major metabolic risk factors: high systolic blood pressure, high total cholesterol, high fasting plasma glucose, high body mass index and impaired kidney functions. In 2040, this study projected they will collectively contribute to more than a third of the total deaths.