The association between long-term statin use and cataract in both primary and secondary prevention of cardiovascular disease – a nationwide, cohort study on 597,605 cataract patients

Abstract

Abstract Background The purpose of the present study was to determine the association between statin treatment duration and cataract in the entire Danish population. Methods We performed a population-based, nested case-control study with data over 25 years using national registries to identify cataract patients, who were matched with a control by age and gender. For each participant, we computed and categorized the statin treatment duration in never users, 1, 5, and 10 years by summation of all redeemed prescriptions. We performed conditional logistic regression analyses in subgroups of the participants according to history of either ischemic heart disease, diabetes, hypertension, or neither of these conditions. Results A total of 597.605 cataract patients were identified and each matched with a control, making an entire cohort of 1.195.210 participants. We identified 271.838 participants with ischemic heart disease, 79.703 participants had diabetes, 216.442 participants had hypertension, and 627.227 participants had neither of these conditions. The subgroups were each adjusted for co-morbidities, low-density lipoprotein cholesterol serum levels, and concomitant pharmacotherapy. We found no increased hazard of cataract with statin treatment duration at 1, 5, or 10 years compared to never using statins in either of the subgroups with ischemic heart disease, diabetes, or hypertension. There was, however, a statistically significant increased hazard of cataract in the subgroup without any known conditions at 1 year of statin use (1.14, 95%-CI [1.06:1.22]), 5 years (1.06, 95%-CI [1.00:1.12]), and 10 years (1.08, 95%-CI [1.01:1.15]). The median low-density lipoprotein level for the ischemic heart disease subgroup was 2.45 mmol/L, 2.20 mmol/L for the diabetes subgroup, 2.80 mmol/L for the hypertension subgroup, and 3.0 mmol/L for the subgroup without conditions. Conclusions We did not find an association between statin use and cataract in patients with ischemic heart disease, diabetes, or hypertension, however, in patients without any of these conditions we found a moderate association with cataract. Funding Acknowledgement Type of funding sources: None.