Statin use may lower the risk for primary open-angle glaucoma (POAG); according to a study published online May 2 in JAMA Ophthalmology. Jae H. Kang, Sc.D., from Brigham and Women’s Hospital in Boston; colleagues evaluated the association between elevated cholesterol levels and statin use and incident POAG among participants (age, ≥40 years) in the Nurses’ Health Study (50,710 participants; followed from 2000 to 2014), the Nurses’ Health Study 2 (62,992 participants; 1999 to 2015), and the Health Professionals Follow-up Study (23,080 participants; 2000 to 2014).
The use of statins (hydroxymethyl glutaryl coenzyme A inhibitors) has with a lower risk of primary open-angle glaucoma (POAG); however, results have conflicting, and little is known about the association between high cholesterol levels and POAG. Cholesterol levels, serum cholesterol levels; length of statin use all self-reported. Therefore the researchers found that among the 136,782 participants in the three cohorts (113,702 women and 23,080 men); so there were 886 incident cases of POAG. For every 20-mg/dL increase in total serum cholesterol, there was a 7 % increase in risk for POAG (risk ratio [RR], 1.07; 95 % confidence interval [CI], 1.02 to 1.11, P = 0.004).
Higher risk for POAG
There was also an association between any self-reported history of elevated cholesterol and a higher risk for POAG (RR, 1.17; 95 % CI, 1.00 to 1.37); but while a history of any statin use was with a 15 % lower risk for POAG (RR, 0.85; 95 % CI, 0.73 to 0.99). Use of statins for at least five years was with a 21 % lower risk for POAG (RR, 0.79; 95 % CI, 0.65 to 0.97; P = 0.02 for linear trend) compared with never use of statins.
Therefore this study highlights the importance of continued investigation into opportunities for the primary prevention of POAG; which will require further elucidation of underlying biological mechanisms and testing of promising interventions in high-risk populations,” write the authors of an accompanying editorial.
In this study of 136 782 participants followed for 15 or more years; higher serum cholesterol levels with a higher risk of POAG. So longer statin use (≥5 years); compared with never use, was with a lower risk of POAG. So carefully determining the association with hyperlipidemia is important to help evaluate the possibility of confounding by indication37 where associations with cholesterol-lowering drugs, such as statins, have been reported.
Consistent with other studies26,38 (eg, a meta-analysis26 reported an RR of 1.40 [95% CI, 0.73-2.68]; for hyperlipidemia history), we observed a trend of higher risk of POAG with higher serum cholesterol levels. This finding indicates that if statins truly lower the risk of POAG and (2) higher cholesterol levels are with elevated POAG risk and higher cholesterol levels with being prescribed more statins; then the confounding bias would have toward the null.