title: Fasting or Nonfasting Lipid Measurements: It Depends on the Question.
abstract: In the 2013 American College of Cardiology (ACC)/American Heart Association Guideline (AHA) on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, low-density lipoprotein cholesterol treatment thresholds have been replaced with a focus on global risk. In this context, we re-examine the need for fasting lipid measurements in various clinical scenarios including estimating initial risk for atherosclerotic cardiovascular disease in a primary prevention patient; screening for familial lipid disorders in a patient with a strong family history of premature atherosclerotic cardiovascular disease or genetic dyslipidemia; clarifying a diagnosis of metabolic syndrome so it can be used to make lifestyle counseling more effective; assessing residual risk in a treated patient; diagnosing and treating patients with suspected hypertriglyceridemic pancreatitis; or diagnosing hypertriglyceridemia in patients who require therapy for other conditions that may further elevate triglycerides. Posing a specific question can aid the clinician in understanding when fasting lipids are needed and when nonfasting lipids are adequate.
authors.affiliation: McGaw Medical Center, Northwestern University, Chicago, Illinois. Electronic address: steven.driver@northwestern.edu.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Driver
authors.affiliation: Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Seth S
authors.initials: SS
authors.lastname: Martin
authors.affiliation: Providence Heart and Vascular Institute, Portland, Oregon; Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
authors.forename: Ty J
authors.initials: TJ
authors.lastname: Gluckman
authors.affiliation: Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Clary
authors.affiliation: Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: McGaw Medical Center, Northwestern University, Chicago, Illinois.
authors.forename: Neil J
authors.initials: NJ
authors.lastname: Stone
mesh_terms: D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D005215:Fasting; D014943:Global Health; D006801:Humans; D008055:Lipids / Q000097:blood*; D009017:Morbidity / Q000639:trends; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*
chemical_list: D008055:Lipids
keywords: atherosclerotic cardiovascular disease; cholesterol; primary prevention; secondary prevention; statins; triglycerides