Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients

Abstract

The aim of the study was to investigate the association between statin use and open-angle glaucoma (OAG) risk in hyperlipidemia patients.We used the research database of the Taiwan National Health Insurance program to conduct a population-based case-control study. A total of 1276 patients with newly diagnosed OAG were identified from 2004 to 2011. Controls comprised of 12,760 patients without glaucoma and were frequency-matched for age, sex, history of diabetes mellitus, and year of hyperlipidemia diagnosis at a 1:10 ratio. Accumulated defined daily doses (DDDs) of statins prescribed during follow-up were calculated. Average statin use was calculated as the sum of DDDs divided by the duration from the initial statin prescription date to the index date (per year), and was subdivided into 3 levels: <30, 30 to 119, and ≥120 DDDs. Comorbidity, including hypertension, depression, and the Charlson comorbidity index, the frequency of eye care visits, and the use of nonstatin cholesterol-lowering drugs, were all considered as confounding factors.For the group with statin use, the adjusted odds ratio of OAG was 1.02 (95% confidence interval 0.90–1.15) when compared with the group without statin use. Subanalysis showed that a high dosage of statin use (≥120 DDD/y) resulted in a1.24-fold increased risk of OAG (odds ratio 1.24, 95% confidence interval 1.03–1.49). The incidence of OAG was increased with the increase of the dosage of statin use (P for trend = 0.0458).Clinicians should be cautious of hyperlipidemia patients with a high dosage of statin use because it might be associated with an increased risk of OAG. Ophthalmologist consultation is necessary for this high-risk group.

Vascular and metabolic comorbidities in open‐angle glaucoma with low‐ and high‐teen intraocular pressure: a cross‐sectional study from South Korea

“…(), using data from the Taiwan National Health Insurance Database, demonstrated that the presence of OAG was associated with a higher prevalence of hyperlipidemia, and a more recently published paper, using the same database, showed an increased risk of OAG in subjects prescribed high doses of statin drugs (Chen et al. ). In agreement with findings from the Taiwan group, this study also demonstrated a positive association between hyperlipidemia and OAG with normal IOP, although the finding was significant only for low‐teen OAG in the subgroup analysis.…”

Hyperlipidemia, Blood Lipid Level, and the Risk of Glaucoma: A Meta-Analysis

“…A further 6696 papers were also excluded following title and abstract review. Of the remaining 42 publications retained for further assessment and a full-text review, 15 papers were excluded for the following reasons: absence of a normal control (n ¼ 1) 17 ; hyperlipidemia or blood lipid level were not exposures (n¼8) [18][19][20][21][22][23][24][25] ; insufficient data to calculate the effect size (n¼5) [26][27][28][29][30] ; or glaucoma, IOP, or OHT were not outcomes (n ¼ 1). 31 The remaining 27 articles were included in this meta-analysis.…”

Use of Statins and Risk of Reducing Glaucoma: Is There a Link

“…In a prospective cohort study, Leung et al [4] reported that after adjusting for other confounding factors, patients with normal tension glaucoma had a reduced risk of visual field progression with the use of simvastatin, and the effect was independent of other systemic medications. In a cross-control study, Chen et al [5] reported that hyperlipidemia patients who use statins had the same risk of developing…”

“…Recent research suggests that statins, which are medications used to lower cholesterol in patients with hyperlipidemia, may have some protection against glaucoma [3] , but it is still inconsistent on whether or not statins are beneficial in patients with glaucoma [2,4,5] .…”