Why should a lipid panel be checked?

From the Guidelines

A lipid panel should be checked to assess cardiovascular health and risk for heart disease, as recommended by the most recent guidelines from 2023 1. This blood test measures several types of fats in your blood, including total cholesterol, LDL ("bad") cholesterol, HDL ("good") cholesterol, and triglycerides. Regular lipid panel screening is recommended for adults starting at age 20, with frequency increasing with age and risk factors. Some key points to consider when deciding on the frequency of lipid panel checks include:

• For most adults, testing every 4-6 years is sufficient,
• Those with existing heart disease, diabetes, or abnormal previous results may need annual testing,
• The test requires fasting for 9-12 hours beforehand for accurate triglyceride measurement. Results help healthcare providers determine if lifestyle changes or medications like statins are needed to manage cholesterol levels. High LDL cholesterol and triglycerides increase risk for plaque buildup in arteries, while high HDL cholesterol is protective. Understanding these values allows for early intervention to prevent heart attacks and strokes, as abnormal lipid levels often cause no symptoms until cardiovascular damage has occurred. Additionally, guidelines suggest that in adults with diabetes, it is reasonable to obtain a lipid profile at the time of diagnosis, at the initial medical evaluation, and at least every 5 years thereafter in patients under the age of 40 years, as stated in 1. It is also recommended to obtain a lipid profile at initiation of statins or other lipid-lowering therapy, 4–12 weeks after initiation or a change in dose, and annually thereafter, as mentioned in 1. Overall, the decision to check a lipid panel should be based on individual risk factors and medical history, with the goal of preventing cardiovascular disease and improving overall health outcomes, as supported by the latest evidence from 1.

From the FDA Drug Label

Prior to initiating therapy with cholestyramine resin, secondary causes of hypercholesterolemia (e.g., poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinemias, obstructive liver disease, other drug therapy, alcoholism), should be excluded and a lipid profile performed to assess Total cholesterol, HDL-C and triglycerides (TG). Serum cholesterol and triglyceride levels should be determined periodically based on NCEP guidelines to confirm initial and adequate long-term response.

A lipid panel should be checked before initiating therapy with cholestyramine resin to assess total cholesterol, HDL-C, and triglycerides, and periodically to confirm initial and adequate long-term response to therapy, as well as to monitor cholesterol reduction 2.

• The goal is to lower LDL-C levels.
• Lipid profiles should be performed to assess total cholesterol, HDL-C, and triglycerides.
• LDL-C levels should be used to initiate and assess treatment response.

From the Research

Importance of Lipid Panels

A lipid panel is a blood test that measures the levels of different types of cholesterol and triglycerides in the blood. It is an essential tool for assessing the risk of coronary heart disease (CHD) and other cardiovascular diseases.

• High levels of total cholesterol and low levels of high-density lipoprotein (HDL) cholesterol are risk factors for CHD 3, 4.
• Elevated cholesterol levels raise the risk of CHD in men and women and in younger and older adults 4.
• Measuring cholesterol levels in adults is necessary to provide an accurate assessment of CHD risk, identify individuals who should lower their cholesterol levels, and reinforce population recommendations 4.

Benefits of Early Screening

Early screening for cholesterol levels is crucial, as atherosclerosis begins early in life, and cholesterol levels in young adults predict CHD risk 30-40 years later 4.

• Cholesterol measurement can be used to motivate lifestyle changes that will reduce the long-term risk for CHD 4.
• Waiting until mid-life to find an elevated cholesterol level loses a significant portion of the benefit 4.
• Recent trials show significant CHD risk reduction in women and older adults, highlighting the importance of cholesterol measurement and lifestyle-based cholesterol lowering in these groups 4, 5.

Lipid Parameters for Measuring Risk

Besides measuring LDL-cholesterol levels, other lipoprotein-lipid measurements, such as non-HDL cholesterol, apolipoprotein (apo) B, HDL cholesterol, and apo A-I, can provide predictive value for cardiovascular disease risk 6.

• Individuals with high concentrations of non-HDL cholesterol or apo B remain at increased cardiovascular risk, even if they achieve low LDL-cholesterol levels with statin therapy 6.
• Low levels of HDL cholesterol or apo A-I are also associated with an increased risk of cardiovascular events, despite normal LDL-cholesterol levels 6.