Boston—A review of trials involving more than 130,000 patients has concluded that use of statins to lower blood pressure is associated with a decreased risk of primary open-angle glaucoma (POAG).

That information is good news, according to the report in JAMA Ophthalmology, because use of the antihypertensive drugs is widespread among older adults, who also have the greatest risk of POAG. The Glaucoma Foundation notes that about 1% of Americans have this form of glaucoma, making it the most frequent type in the United States. POAG is a progressive condition and is the most common cause of irreversible blindness worldwide.

To reach that conclusion, a study team led by researchers from Brigham and Women’s Hospital and Harvard Medical School conducted a population-based cohort study of 886 incident cases of POAG. That was a subset of 136,782 participants who contributed person-time for up to 15 or more years and provided repeated updated data on statin use and cholesterol levels.

Researchers determined that 5 or more years of statin use was associated with a 21% lower risk of POAG, while every 20-mg/dL increase in total serum cholesterol was associated with a 7% increase in risk of POAG.

Specifically, the study used data collected biennially from participants aged 40 years or older who were free of glaucoma and reported eye examinations within three population-based cohorts: the Nurses’ Health Study (N = 50,710; followed up from 2000–2014), the Nurses’ Health Study 2 (N = 62,992; 1999–2015), and the Health Professionals Follow-up Study (N = 23,080; 2000–2014). Analysis was performed in January 2019.

Results indicate that any self-reported history of elevated cholesterol was also associated with a higher risk of POAG (relative risk [RR], 1.17 [95% CI, 1.00-1.37]), while a history of any statin use was associated with a 15% lower risk of POAG (RR, 0.85 [95% CI, 0.73-0.99]).

The study team points out that the association between use of statins for 5 or more years versus never-use of statins and risk of POAG was more inverse in those who were aged 65 years or older (RR, 0.70 [95% CI, 0.56-0.87] versus younger patients (RR, 1.05 [95% CI, 0.68-1.63]; P = .01 for interaction).

“Among adults aged 40 years or older, higher serum cholesterol levels were associated with higher risk of POAG, while five or more years of statin use compared with never use of statins was associated with a lower risk of POAG,” the study authors conclude.

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