Association of Statin Use and High Serum Cholesterol Levels With Risk of Primary Open-Angle Glaucoma.
JAMA Ophthalmol
; 137(7): 756-765, 2019 07 01.
Article
em En
| MEDLINE
| ID: mdl-31046067
ABSTRACT
Importance The use of statins (hydroxymethylglutaryl coenzyme A inhibitors) has been associated with a lower risk of primary open-angle glaucoma (POAG); however, results have been conflicting, and little is known about the association between high cholesterol levels and POAG. Objective:
To assess the association of elevated cholesterol levels and statin use with incident POAG. Design, Setting, andParticipants:
This study used data collected biennially from participants aged 40 years or older who were free of glaucoma and reported eye examinations, within 3 population-based cohorts the Nurses' Health Study (N = 50â¯710; followed up from 2000 to 2014), the Nurses' Health Study 2 (N = 62â¯992; 1999-2015), and the Health Professionals Follow-up Study (N = 23â¯080; 2000-2014). Incident cases of POAG were confirmed by medical record review. The analyses were performed in January 2019. Exposures Biennially updated self-reported information on elevated cholesterol level status, serum cholesterol levels, and duration of statin use. Main Outcomes andMeasures:
Multivariable-adjusted relative risks (RRs) and 95% CIs were estimated using Cox proportional hazards regression models on pooled data, with stratification by cohort.Results:
Among the 136â¯782 participants in the 3 cohorts (113â¯702 women and 23â¯080 men), 886 incident cases of POAG were identified. Every 20-mg/dL increase in total serum cholesterol was associated with a 7% increase in risk of POAG (RR, 1.07 [95% CI, 1.02-1.11]; P = .004). Any self-reported history of elevated cholesterol was also associated with a higher risk of POAG (RR, 1.17 [95% CI, 1.00-1.37]). A history of any statin use was associated with a 15% lower risk of POAG (RR, 0.85 [95% CI, 0.73-0.99]). Use of statins for 5 or more years vs never use of statins was associated with a 21% lower risk of POAG (RR, 0.79 [95% CI, 0.65-0.97]; P = .02 for linear trend). The association between use of statins for 5 or more years vs never use of statins and risk of POAG was more inverse in those who were older (≥65 years RR, 0.70 [95% CI, 0.56-0.87] vs <65 years RR, 1.05 [95% CI, 0.68-1.63]; P = .01 for interaction). Conclusions and Relevance Among adults aged 40 years or older, higher serum cholesterol levels were associated with higher risk of POAG, while 5 or more years of statin use compared with never use of statins was associated with a lower risk of POAG.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Glaucoma de Ângulo Aberto
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Colesterol
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Inibidores de Hidroximetilglutaril-CoA Redutases
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Hipercolesterolemia
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article