In the 2013 American College of Cardiology (ACC)/American Heart Association Guideline (AHA) on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, low-density lipoprotein cholesterol treatment thresholds have been replaced with a focus on global risk. In this context, we re-examine the need for fasting lipid measurements in various clinical scenarios including estimating initial risk for atherosclerotic cardiovascular disease in a primary prevention patient; screening for familial lipid disorders in a patient with a strong family history of premature atherosclerotic cardiovascular disease or genetic dyslipidemia; clarifying a diagnosis of metabolic syndrome so it can be used to make lifestyle counseling more effective; assessing residual risk in a treated patient; diagnosing and treating patients with suspected hypertriglyceridemic pancreatitis; or diagnosing hypertriglyceridemia in patients who require therapy for other conditions that may further elevate triglycerides. Posing a specific question can aid the clinician in understanding when fasting lipids are needed and when nonfasting lipids are adequate.

In patients with cardiovascular diseases, adherence to medication is a fundamental prerequisite for pharmacological therapy to be effective. Nonadherence to medication is a major public health problem that compromises the effectiveness of therapies and results in suboptimal clinical outcomes. The behaviour of nonadherence is complex and is strongly influenced by an interaction between various factors, such as patient education, communication between patients and physicians, drug dosing schedules, and access to health care. Interventions have been implemented to target these barriers to adherence; however, individual interventions have generally been associated with fairly modest improvements in adherence. Financial incentive schemes and modern technology, such as mobile telephone applications, are being harnessed as novel strategies to improve adherence. Ultimately, multifaceted strategies tailored to individual patients are likely to be required to improve long-term adherence to medication and consequently enhance patient health.

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Tobacco, physical inactivity, and poor diet cause more than a third of all US deaths. 1 During the past half decade, great progress has been made on tobacco control, with cigarette smoking rates reaching an all-time low of 16.8% in 2014. 2 However, during roughly the same period, the prevalence of overweight and obesity among US adults has increased to an all-time high of 69% in 2012. 3 The US Department of Health and Human Services addressed smoking cessation in their practice guidelines; a key recommendation was for clinicians to help smokers quit by using the 5 A's model for treatment of tobacco use and dependence: ask all patients about tobacco use, advise current smokers to quit, assess willingness to quit, assist with quitting, and arrange for follow-up. 4 Similarly, the 2013 American College of Cardiology/American Heart Association lifestyle guideline recommended that adults consume a healthier diet and engage in regular aerobic activity.