Below are listed the recommendations of how and when to measure baseline lipid levels. The main determinants are the expected triglyceride values, and family history of premature cardiovascular disease or genetic lipid disorders.
In adults ≥20 and not on lipid-lowering therapy, measurement of either a fasting or a non-fasting plasma lipid profile is effective in estimating ASCVD risk and documenting baseline LDLc
In adults ≥20 and in whom an initial non-fasting lipid profile reveals a triglycerides level ≥400 mg/dL, a repeat lipid profile in the fasting state should be performed for assessment of fasting triglyceride levels and baseline LDLc
For patients with an LDLc <70 mg/dL, measurement of direct LDLc or modified LDLc is reasonable in improving accuracy over the Friedewald formula
In adults ≥20 and without a personal history of ASCVD but with an FHX of premature ASCVD or genetic hyperlipidemia, measurement of a fasting plasma lipid profile is a reasonable initial evaluation in understanding and identifying familial lipid disorders.
