Lipid assessment for vascular risk can be simplified by removing the need for patients to fast before tests, UK researchers have shown.
Removing the requirement that patients fast does not compromise the test's predictive power, the team found.
Triglyceride levels also do not need to be measured, the researchers believe, unless there are reasons other than vascular risk for measuring them.
Data from 302,430 patients was assessed by Emmanuele Di Angelantonio of the University of Cambridge and colleagues from the Emerging Risk Factors Collaboration.
Patients were followed for over nine years on average. During the follow-up period, 3,928 CHD deaths, 2,534 ischaemic strokes and 8,857 non-fatal MIs occurred.
The researchers found that hazard ratios for CHD risk were at least as strong in participants who did not fast as in those who did.
In addition, triglyceride concentration was not independently related with CHD risk, once other risk factors, including HDL-C and non-HDL-C, had been accounted for.
'For population-wide assessment of vascular risk, triglyceride measurement provides no additional information about vascular risk given knowledge of HDL-C and total cholesterol levels,' the researchers said.
The researchers also assessed the predictive power of apolipoprotein assessment. They found that hazard ratios with HDL-C and non-HDL-C were nearly identical to those seen with apolipoproteins.
'This finding suggests that current discussions about whether to measure cholesterol levels or apolipoproteins in vascular risk assessment should hinge more on practical considerations than on major differences in strength of epidemiological associations,' they said.