Non-fasting lipid (cholesterol) testing will soon be the norm, with new guidelines set to be released in Australia next year.

While some laboratories and doctors are already accepting non-fasting samples, under the current recommendations patients referred for lipid testing are generally asked to fast for eight to 12 hours beforehand.

However, the latest evidence shows that non-fasting tests are just as good at predicting cardiovascular risk and much more convenient for patients.

But a fasting sample will still be preferred in some cases, says Professor Graham Jones, a chemical pathologist and spokesperson for Pathology Awareness Australia.

UK guidelines already endorse non-fasting lipid profiles and a consensus statement published this year in the European Heart Journal also recommended them.

As most people would usually have just a couple of hours between meals, the EHJ article says non-fasting tests may be more reflective of the patient’s usual status.

“We already know that a percentage of people don’t present for pathology tests when a doctor requests them and so it’s important that we remove barriers to testing where possible,” says Prof Jones.

However, he says it is still recommended to avoid alcohol and fatty foods on the days of testing be avoided.

Read more about changes to cholesterol testing here

The post Cholesterol testing: changes imminent first appeared on Know Pathology Know Healthcare.

Cholesterol is part of the lipid profile tests that are used to assess a person’s cardiovascular risk and also to monitor patients who are being treated for an existing cardiovascular condition.

The tests include measurements of total cholesterol, HDL cholesterol and triglycerides. Patients are asked to fast before having the test because food in the system can affect results.

Test results are compared to a recommended range; this is the scale pathology labs use to report whether a lipid result is within a low or high cardiovascular risk range.

Contemporary thinking is that the effect of food on a person’s test result can simply be taken into account when evaluating the results of the initial test, as evidence shows that any difference in the test results because of the patient not fasting is usually small.

Should the lipid profile reveal something of concern, or if doctors feel a comparison is needed, the test can be repeated when the patient has fasted to give doctors information to compare.

This is good news for patients as fasting for eight hours can obviously be difficult and inconvenient. It is also welcome news for pathology collection centres that may have to turn away patients who are not aware of the fasting requirement and arrive for their test after a recent meal.

Chemical pathologist Dr Lee Price said: “Many patients aren’t told by their GP or referring doctor that they should fast, or they forget to, so are turned away when they go for the test.

Also fasting is often inconvenient. Many patients will choose to have the test first thing in the morning when collection centres are busiest, which is inconvenient for patients and staff.”

When asked if a patient could even present for a test straight after lunch, Dr Price cautioned that eating right before a blood test would still not be recommended. However, patients would only need to refrain from food for about two hours before the test, rather than eight.

Dr Price says that how test results are interpreted and how cardiovascular risk is assessed is now moving on; “We now want to know what levels are the majority of the time – as most people, most of the time are in a non-fasting state.”

There is still a place for fasting tests for comparison purposes and for assessment of those being treated for existing conditions, such as those who have had a heart attack or stroke who may be taking statin drugs.

With an ageing population and concerns about growing rates of obesity and chronic health problems, cardiovascular risk assessment is fairly common and is unlikely to decrease any time soon. This means many patients will benefit from the move to non-fasting tests and doctors will be able to more easily assess risk and take appropriate action.

The post From fasting to faster; cholesterol testing changes are better for all first appeared on Know Pathology Know Healthcare.