After normal food intake, LDL-C differs minimally with time.S2.2-10 Fasting and nonfasting TC and HDL-C levels appear to have fairly similar prognostic value and associations with CVD Thus, nonfasting samples can be used for risk assessment in primary prevention and for assessment of baseline LDL-C levels before the ini- tiation of a statin in primary and secondary prevention. If more precision is necessary, fasting lipids can be mea- sured, but a nonfasting sample is reasonable for most situations. The unreliability of the Friedewald-calculated LDL-C levels appears to be greatest at lower levels of Mar- tin et al. have validated an approach to estimating LDL- C levels from a standard lipid panel when LDL-C levels is <70 mg/dL (<1.8 mmol/L) and triglycerides levels are Recommendation-Specific Supportive Text 1. If an individual has ingested an extremely high-fat meal in the preceding 8 hours, it may be prudent to assess lipids on another day after counseling the patient to avoid such meals. Documentation of the baseline LDL-C level will be useful in assessing the patient s response to the initiation of statin therapy, if that is undertaken.S2.2-1 S2.2-6 Similarly, given relatively modest differences in LDL-C levels associated with the postprandial state, use of a nonfasting sample is effective to document baseline lipid levels before initia- tion of statin therapy in individuals with clinical In adults with a family history of premature ASCVD or genetic hyperlipidemia, a fasting lipid profile is reasonable for initial evaluation. 2. Given relatively modest differences in LDL-C lev- els between fasting and non-fasting samples, the latter is generally adequate to document baseline lipid levels prior to initiation of statin 3. The unreliability of the Friedewald-calculated LDL-C levels rises at lower levels of LDL-C, par- ticularly <70 mg/dL (<1.8 mmol/L). 