05/28/2026
Does your P*P still make you fast for labs ? 🧐
Hypercholesterolemia is the strongest modifiable risk factor for coronary heart disease, and measurement of plasma lipid levels is an integral part of overall cardiovascular risk assessment. Providers and patients are used to having lipid profiles measured when the patient has fasted because of the assumption that fasting lipid profiles avoid substantial variability in the results caused by eating. However, recent evidence has shown that nonfasting lipid testing is more suitable. 🙌
Large population studies performed over the last decade showed that serum lipid levels after eating show only minor variation. Other high-quality studies have shown that nonfasting lipid levels predict risk for coronary heart disease and stroke better than fasting lipid levels.
One study suggested that this is due to the added atherogenic effect of cholesterol in remnant lipoproteins, including intermediate density lipoproteins and chylomicron remnants, which cross the vascular endothelium like LDL and become trapped in the artery wall, contributing to plaque formation. Remnant cholesterol is captured along with LDL cholesterol in the non-HDL cholesterol level regardless of the time since eating.
Nonfasting lipid testing has been adopted as the norm in Denmark since 2009. In Canada, reporting of the nonfasting complete lipid profile, including LDL cholesterol and triglyceride levels, was adopted in Alberta in 2014 and has been recommended by the College of Family Physicians of Canada lipid guideline since 2015.
This is not something new, and should always be the standard for cardiovascular risk assessment ❤️
Education is key 🔑
