Non-fasting lipids: a change in practice

Over the past decade, multiple guidelines by cardiovascular societies around the world have advised that testing for non-fasting lipids be recommended in preference to fasting lipids to assess for cardiovascular risk.1–4 However, Australia’s most recent guideline on cardiovascular risk was published in 2012 prior to the aforementioned worldwide changes and continues to suggest the use of a fasting lipid profile to assess absolute cardiovascular risk.5 Australian general practitioners (GPs) and their patients may not be aware of this global paradigm shift in testing, which has significant benefits to the patient, doctor and society. Indeed, one could argue that the non-fasting state is more representative of cardiovascular risk, as humans spend most time in the postprandial condition. We highlight below current recommendations from around the world and the rationale for shifting from fasting to non-fasting