While the effects of lipid on mortality is uncertain, it may be the result of some lipid lowering medications causing a reduction in cardiovascular disease. The role of statins in cancer is unclear and their use in pregnancy and breast feeding needs to be exercised with caution by clinicians.
This paper reviews lipidemia causes and treatments as defined by literature. It provides clinical examples for the management of lipotoxicity that are of high clinical relevance to physicians and medical students.
It is known that an elevated total cholesterol level is an independent risk factor that increases the risk of both coronary heart diseases and vascular diseases such as ischemic stroke. Lipid levels in the patient's blood depend on how often the patient eats, exercise, and drinks and also whether or not they take any medications. To evaluate the presence of any type of lipid in the blood and also to check for heart diseases a detailed history, a physical examination, as well as laboratory tests are advisable. These tests can also help clinicians make diagnoses, and thus, implement the necessary treatment for the disease depending on what type of diagnosis has been established.
Lipid therapy is commonly used in lipidemic patients. It is not effective for preventing cardiovascular disease in statin-treated individuals, suggesting the need to tailor therapy beyond LDL-reduction goals.
There are around 20 million people who develop lipidemia a year and this is likely to grow to over 40 million within the next 25 years.
The most prevalent definition of hyperlipidemia in the Framingham Heart Study, used by nearly all investigators, was the >2.5rd-99th percentile limits for chylomicron, LDL, and plasma cholesterol. Using the >2rd-99th percentile limits for Hcy, TGs, triglycerides, and ApoB, Hcy was more prevalent than the other lipid measurements in both the men and the women, which suggests that it may be of a greater concern.
There are a number of potential reasons for the apparent age of onset of lipoprotein [elevations], including the possibility of age-dependent change in the biological pathways that lead to cholesterol accumulation.
Most cases of hyperlipidemia run in families; it may be due to common genetic factors. Data from a recent study strengthen the concept that a large number of sporadic hyperlipidemic cases are familial and underscore the importance of screening family members of patients with familial hyperlipidemias for hyperlipidemia.
In the developed world as well as in our patient population, lipidemia seems to be a more complex pathophysiological condition involving systemic factors; and so a multifactorial approach is always necessary.
Diabetes (type 1 or 2) is a significant risk factor for cardiovascular disease and accounts for about 10% of all deaths in the United States. Although the connection between diabetes and other forms of hyperlipidaemia has been made well known, research was largely restricted to the effects of diabetes on dyslipidaemia and atherosclerosis. Findings from a recent study of clinical trials performed in the United States on this topic have been very positive, however, and most researchers believe that the current guidelines for lowering the LDL (bad) level in diabetic patients are too ambitious. Lipidemia is an important issue, however, and, unfortunately, there currently is too little data available for us to develop consensus regarding the optimal treatment regimen.
A significant number of trial reports published in the last decade have used atorvastatin to assess its clinical impact or in conjunction with conventional antihypertensive treatment, and there are numerous reports in the literature. There is strong evidence to suggest efficacy or safety considerations for patients receiving atorvastatin at this dosage.