Trade Name: LIPITIN TAB 20 MG
Generic Name: Atorvastatin INN

What is of Lipid?
Lipid : Lipids are ester like compounds of fatty acids, which are insoluble in water but soluble in fat solvents like chloroform, ether, benzene etc.

What are the different kinds of lipid?

Classification of lipid :
Lipids are classified into
A. Simple lipid : Ester of fatty acids with various alcohol like glycerol and other higher alcohol.
B. Compound Lipid : Ester of fatty acids with alcohols and containing other groups like PH4, Sugar, Protein, nitrogenous substances etc. e.g. Phospholipids, Lipoproteins, Glycolipids, Sulpholipids etc
C. Derived lipid : Substances derived from hydrolysis of simple lipids and compund lipids are called derived lipid. e.g. saturated and unsaturated fatty acids, sterols etc.

What is Lipoprotein?
Lipoprotein : Lipids are carried in plasma in combination with protein called lipoprotein. Lipoproteins are composed of triglyceride, phospholipids, cholesterol and one or more specific protein (Apoprotein)

What are the different kinds of Lipoprotein?
Classification of Lipoprotein : Lipoproteins are classified on the basis of their density, lipid composition, and apolipoprotein content. Six classes of lipoproteins are
1. VLDL (very low density lipoprotein)
2. IDL (Intermediate density lipoproteins)
3. LDL (Low density lipoprotein)
4. HDL (High density lipoprotein)
5. [Lp(a)] (Lipoprotein a)
6. Chylomicrons & chylomicron remnants

LDL cholesterol
Low-density lipoprotein, or LDL cholesterol, is known is "the bad cholesterol." Excess LDL builds up on our arteries and may lead to heart disease. The higher the level of LDL, the higher risk for heart disease. Lowering elevated LDL cholesterol can prevent heart attacks and save lives.

HDL Cholesterol
High-density lipoprotein, of HDL cholesterol, has earned the nickname "the good cholesterol : that's because it is believed to remove cholesterol from the blood. High levels of HDL in your blood may help to reduce our risk of coronary heart disease. A low lever can increase the risk of heart disease. 

Triglycerides
Triglycerides are another type of fat in our bloodstream. Persons with a high blood-triglyceride level may also have a high LDL. Those with a high triglyceride level in addition to an elevated LDL cholesterol level may be at further risk of coronary heart diseases.

What is Hyperlipidemia?
Hyperlipidemia has been defined as plasma cholesterol and triglyceride levels that exceed normal levels, which usually have been arbitrarily defined as the 95th percentile of levels o the general population.

What is Hyperlipoproteinemia?
Increased lipids in the blood due to either an increased rate of synthesis, or decreased rate of breakdown of lipoproteins. The lipoproteins transport triglycerides and cholesterol in the plasma. Clinically, an increased level of lipoproteins may cause atherosclerosis and pancreatitis.

What are the different types of Hyperlipoproteinemia?
According to etiology of the disease it can be classified as following

Primary Hyperlipoproteinemia?
Primary Hyperlipoproteinemia can result from a single inherited gene defect or more commonly, are caused by a combination of genetic and biochemical defect to either lipoprotein lipase activity or one o the cofactors essential to the function of that enzyme.

Secondary Hyperlipoproteinemia :
In this case Hyperlipoproteinemia develops as a result of certain endocrine and metabolic disorders, including diabetes mellitus; glycogen storage disease; Cushing syndrome; anorexia; use of drugs such as alcohol, oral contraceptives and glucocorticoids; renal disease; liver disease.

What is Cholesterol?
Cholesterol is a derived lipid, which is a waxy, fat-like substance that is present in every cell in our body. Our liver produces enough cholesterol for our body. Certain foods provide additional amounts of Cholesterol, which may be more than our body needs. While some Cholesterol in our blood is essential to our health, too much can be harmful. If our Cholesterol level is too high, it may increase our risk of heart disease. There are many reasons for a high Cholesterol level. These include diet and family history. Obesity or some diseases such as diabetes can also contribute to a high Cholesterol level.

How does the Cholesterol level measure?
The blood cholesterol level is measured as milligrams of cholesterol per deciliter of blood (mg/dL) If the LDL is between 130 and 159 mg/dL, doctor will look at other risk factors for heart disease to determine whether one needs medical advice for cholesterol lowering, primarily with diet (Step-1) physical activity, and weight control, or if one can lower it on his own.

Your Cholesterol reading - What should it be?
Cholesterol readings you receive from your medical provider generally include total cholesterol, LDL cholesterol, and HDL cholesterol levels. It is important to look at all three readings, not just the total cholesterol. The following are recommended goals for your cholesterol readings :

What are the risk factors for Heart Diseases?
Risk factor for Heart Disease

• High LDL cholesterol 

• Low HDL cholesterol level (less than 35 mg/dl)

• High blood pressure v Diabetes

• Increasing age 

• Smoking

• Family history of early heart disease (a parent or sibling less than 55 years old if male, or 65 years old if female).
   

How does a high cholesterol level contribute to heart disease?
A healthy artery has a smooth, even surface. When too much cholesterol in bloodstream, the excess is deposited in arteries, including the coronary arteries, where it contributes to the narrowing and blockages that cause the sign and symptoms of heart disease.
Narrowing of the coronary arteries that feed the heart causes heart disease. Like any muscle, the heart needs a constant supply of oxygen and nutrients, which are carried to it by the blood in the coronary arteries. When the coronary arteries become narrowed or clogged by cholesterol and fat deposits, a process calle atherosclerosis.

Due to atherosclerosis coronary arteries can not supply enough food to the heart, the result is coronary heart disease (CHD)

If not enough oxygen-carrying blood reaches the heart, one may experience chest pain called angina.

If the blood supply to a portion of the heart is completely cut off by total blockage of coronary arteries, the result is heart attack.

When a major artery supplying blood to the brain, the blood flow can be completely blocked, the result can be a stroke.

What makes Your Cholesterol High or Low?
Your blood cholesterol level is affected not only by what you eat but also by how quickly your body makes LDL ("bad") cholesterol and disposes of it. In fact, your body makes all the cholesterol it needs, and it is not necessary to take in any additional cholesterol from the foods you eat.

Many factors help determine whether your LDL-cholesterol level is high or low. The following factors are the most important :

• Heredity 

• What you eat

• Weight

• Physical activity/exercise

• Age and sex

• Alcohol

• Stress
   

How common is high cholesterol?
One national survey estimated that, overall, 30% of all American adults - about 56.5 million people - have a high LDL cholesterol that requires diet or drug therapy. According to the same survey, only 34% of these individuals have been diagnosed with high cholesterol. That means that two out of three persons who should be treated for high cholesterol do not even know they have it.

How high cholesterol be controlled?
Sometimes changes in diet and lifestyle may be enough to lower cholesterol to a desirable level. Other times, diet and lifestyle changes must be combined with medication.
Once the cholesterol goal is rached, howerver, we must continue to follow our doctor's advice to maintain a health cholesterol level. Remember that high cholesterol cannot be cured, but it can be controlled. Our cholesterol level will likely creep up again if we stop treatment. We will need to maintain a healthy lifestyle and keep our cholesterol at an acceptable level. Make changes in our cholesterol-lowering program only on the recommendation of your health care professional.

Cholesterol Lowering Medications and You
If following a low-fat, low-cholesterol diet and increasing your physical activity have not lowered your risk for developing CHD, your doctor may consider prescribing a cholesterol lowering medication. If after about 6 months worth of trying to change life habits, your LDL level is 190 mg/dL or higher and you have less than 2 other risk factors for heat disease, you may need to take medicine. If after 6 months of life habit changes you LDL level is 160 mg/dL or higher and you have 2 or more other risk factors, your doctor many consider prescribing cholesterol-lowering medication. If your doctor prescribes medicine, you also will need to :

• Follow your cholesterol-lowering diet.

• Be more physically active.

• Lose weight if overweight.

• Control of your other heat disease risk factors, including smoking, high blood pressure, and diabetes.

Taking all these steps together may lessen the amount of medicine you need or make the medicine work better and that reduces your risk for developing heart disease. The following is a description of cholesterol-lowering medicines.

A. HMG-CoA reductase inhibitors : Atorvastatin, Lovastatin, Pravastatin, Simvastatin and Fluvastatin
B. Niacin (Nicotinic acid)
C. The fibrates- Clofibrate and Gemfibbrozil
D. Bile acid binding resins : Cholestyramine and Colestipol
E. Probucol
F. Combination Drug Therapy