Is fasting necessary before a cholesterol test?

The new recommendations represent a joint consensus statement from the European Atherosclerosis Society and European Federation of Clinical Chemistry and Laboratory Medicine involving 21 global medical experts from Europe, Australia and the US.

If you are aged 20 or older and have not been diagnosed with cardiovascular disease, the American Heart Association recommends having your cholesterol levels checked every four to six years as part of a cardiovascular risk assessment.

Generally you're required to fast, consuming no food or liquids other than water, for nine to 12 hours before the test for cholesterol and triglyceride measurement.

So far fasting has been required before in all countries except Denmark, where non-fasting blood sampling has been used since 2009.

The latest research from University of Copenhagen and published in the European Heart Journal, shows that cholesterol and triglyceride levels are similar whether you fast or not, which is beneficial for many patients for whom fasting can be a problem.

The research suggests that patients no longer need to fast.

"This will improve patients compliance to preventive treatment aimed at reducing number of heart attacks and strokes, the main killers in the world," says Clinical Professor Borge Nordestgaard, Department of Clinical Medicine, Herlev Hospital, University of Copenhagen.

In Denmark, the use of random, non-fasting cholesterol testing at any time of the day irrespective of food intake has been used successfully since 2009. Patients, doctors and laboratories have all benefited from this simplified procedure. For people at work, children, patients with diabetes and the elderly it is particularly beneficial not to have to fast before blood sampling for cholesterol and triglyceride testing.

This is the first international recommendation that fasting is no longer necessary before cholesterol and triglyceride testing. For cholesterol testing after a fast, patients are often inconvenienced by having to return on a separate visit and may default on essential testing.

"That more patients will have their cholesterol and triglycerides measured will facilitate advice from their doctors on how best to prevent heart attacks and strokes in the future. We hope that non-fasting cholesterol testing will make more patients together with their doctors implement lifestyle changes and if necessary statin treatment to reduce the global burden of cardiovascular disease and premature death," adds Nordestgaard.

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