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Jun 17, 2016

Experts Challenge the Need for Fasting Cholesterol Tests

Fasting for cholesterol tests may soon be a thing of the past, based on new recommendations.

Fasting for cholesterol tests may soon be a thing of the past, based on a recent statement that recommends non-fasting blood samples for routine assessment of the lipid profile.

Published in the European Heart Journal, this statement addressed a group of blood tests called the lipid profile, which help assess risk for developing heart disease. The lipid profile measures cholesterol and triglycerides and typically requires 8–12 hours of fasting for accurate results, which can be quite an inconvenience. Many patients have to return on a separate visit for a fasting lipid profile and even when tests are scheduled, compliance with fasting is a challenge.

But are fasting blood tests actually necessary? According to experts from the European Atherosclerosis Society and European Federation of Clinical of Clinical Chemistry and Laboratory Medicine, the answer is no.

After reviewing the latest evidence, experts conclude that non-fasting blood tests are just as effective in assessing cardiovascular risk in adults. Extensive research shows that non-fasting lipid profiles don’t actually change significantly within 1–6 hours after a meal. Non-fasting tests work just as well in predicting risk for heart disease—the leading killer of men and women in the United States.

Based on evidence, authors recommend that “non-fasting blood samples be routinely used for the assessment of plasma lipid profiles.” Authors also provide guidelines for test results, which help flag abnormal cholesterol or triglyceride levels. The only catch is that when non-fasting triglycerides are elevated (above 440 mg/dL), clinicians should consider a fasting blood test to further assess cardiovascular risk.

Of course, current guidelines still recommend traditional fasting tests when assessing the lipid profile. So most of us will still have to fast before having our cholesterol and triglycerides checked. But in the future, experts hope that guidelines will be updated to reflect new evidence and recommendations.  

Questions for You to Consider

  • What are the risks associated with high cholesterol?
  • High cholesterol can cause atherosclerosis, the build-up of plaque on artery walls. This accumulation of deposits can cause serious complications, such as chest painheart attack and stroke. High cholesterol is largely preventable and treatable, so getting screened and making healthy lifestyle choices can go a long way in controlling cholesterol levels.
  • At what age should I worry about my cholesterol?
  • More than one-third of Americans have high cholesterol and risk for high cholesterol increases with age. However, high cholesterol can be a problem at any age. It’s estimated that 22% of adults in their 20s have high cholesterol and 62% of adults in their 50s have high cholesterol. It’s important to have cholesterol checked regularly and make healthy lifestyle choices like eating healthy and staying active, which help control cholesterol levels.

Featured Video

Total cholesterol is made up of both HDL ("good" cholesterol) and LDL, the "bad" cholesterol—in addition to triglycerides—that you have to keep low.


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