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Dec 10/24, 2012

Should We Fast Before We Measure Our Lipids?

Arch Intern Med. 2012;172(22):1705-1706. doi:10.1001/jamainternmed.2013.1771

Imagine a primary care provider in her clinic at 3 PM on a Tuesday afternoon. She is seeing a 62-year-old man who took time off from work to go see his physician at the urging of his wife. The patient has not been seen for several years. He is obese and his blood pressure is elevated, but he has no complaints today. After discussing weight loss and hypertension, the diligent primary care provider is quickly moving through the well care checklist and comes to the issue of a lipid profile. It has been several years since the patient's lipid levels have been checked. The provider is confronted with a dilemma. Does she suggest that the patient take more time off from work to return for a fasting lipid profile, or should she just send him directly to the laboratory? What is the chance that her patient might miss the follow-up appointment to get the fasting lipid profile? Does she really need a fasting profile?