It is well known that cataracts are a leading cause of low vision in the elderly, but little is known about how to prevent them. For one, the longer a person lives, the more likely that person is to develop cataracts. Statins, such as Lipitor, Mevacor, and Crestor, are primarily prescribed to help extend our lifespan by reducing the risk of heart attacks and strokes. Increasing one’s lifespan may thereby increase the risk of cataracts. However, is it possible that the statins themselves can increase that risk?
Cataracts are cloudy patches that form in the lens of the eye. The result is often blurred, low vision, which can affect quality of life. This condition is typically treatable and is not fatal, but it affects millions of Americans and requires eye surgery to repair. In addition, treatments can be costly, impacting pocketbooks, insurance, and Medicare. Surgery is highly successful, with rates consistently hovering around 98-99%.
Statins are a type of medication that is prescribed to help lower cholesterol levels. Lowering “bad” cholesterol levels can, in turn, can help decrease the risk of stroke, heart attack, and other coronary heart diseases. A dose must be taken daily to regulate the enzymes that control cholesterol production and “bad” cholesterol removal by the liver. This medication is not without controversy, however, as some questions have arisen concerning the necessity of prescriptions. It is widely accepted that daily statins are effective at reducing risks of heart attack and stroke in patients with heart disease or who have already suffered an event. However, it is less clear whether taking statins as a preventative significantly helps reduce the risk for other patients or not.
In November 2013, the Ophthalmology publication of the Journal of the American Medical Association (JAMA) shared the results of a study potentially linking statin use and cataract risk in patients. The initial study compared 6972 matched pairs of statin users and nonusers. The team of six doctors leading researching, representing eight medical systems or university departments, found that cataracts were more common in statin users than in nonusers. This study was tightly controlled, using only patients from within a military health care system. The patients had equal access to a standardized system of health care, reducing the amount of variables involved in the research process. This was one of the research team’s primary objectives, which is why the results are so important.
Despite the prominence and conviction of the 2013 study, questions remain. The publication referenced numerous other investigators and research reports, which may offer a conflicting message overall. Some observational studies indicated that statins could decrease the risk, while others suggested that a component of the medication could directly lessen aging of the eye lens. The 2013 study is unique in that all of the patients had similar access to health care facilities that also operated at a similar standard, which could indicate more accurate results.
In addition, this study’s results do agree with another study’s, which was published in Optometry and Vision Science and led by researchers at the University of Waterloo, Canada. Their research suggests that age-related cataracts can be linked to both statin use and type 2 diabetes. There was not, however, found to be a direct correlation between those two risk factors.
More recently, a 2015 effort by the University of British Columbia analyzed information from Canadian and U.S. health databases. They also found a link between statin use and increased cataract risk.
If statins do increase the risk of cataracts, then doctors and researchers must also look at how the medication is being prescribed. Additional studies must address the effectiveness of statin use for heart attack and stroke prevention versus use only in patients with known heart disease.
The daily use of statins may contribute to or cause low vision problems such as cataracts, but do the benefits outweigh the risk? Given that cataracts are primarily an age-related issue, perhaps statins should be used in an effort to extend that lifespan. Either way, however, doctors and patients must be well aware of the risks and possible side effects. Unless an existing condition warrants the prescription of statins, perhaps it is better to hold off and avoid any potential, unwanted side effects.