Statins and cataracts

[Jerry_Cahill]

I saw a small piece that suggests that statins limit the cholesterol in the eyes and may then cause cataracts. Anyone know more about this?

[JKPrime]

There is no clear evidence that the use of statins increases the risk of cataracts see

[AnUser]

Atorvastatin is better than Rosuvastatin for that.

Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial (2023)

Results 4341 of the 4400 participants (98.7%) completed the trial. Mean daily dose of study drugs was 17.1 mg (standard deviation (SD) 5.2 mg) in the rosuvastatin group and 36.0 (12.8) mg in the atorvastatin group at three years (P<0.001). The primary outcome occurred in 189 participants (8.7%) in the rosuvastatin group and 178 (8.2%) in the atorvastatin group (hazard ratio 1.06, 95% confidence interval 0.86 to 1.30; P=0.58). The mean low density lipoprotein (LDL) cholesterol level during treatment was 1.8 mmol/L (SD 0.5 mmol/L) in the rosuvastatin group and 1.9 (0.5) mmol/L in the atorvastatin group (P<0.001). The rosuvastatin group had a higher incidence of new onset diabetes mellitus requiring initiation of antidiabetics (7.2% v 5.3%; hazard ratio 1.39, 95% confidence interval 1.03 to 1.87; P=0.03) and cataract surgery (2.5% v 1.5%; 1.66, 1.07 to 2.58; P=0.02). Other safety endpoints did not differ between the two groups. If you are using rosuvastatin, would you switch to atorv…

[Jerry_Cahill]

I would agree with that. The money is in High Cholesterol studies. In fact there is an eye issue if your cholesterol level is too high, You may remember Tim Russert had a massive heart attack and his LDL was 68 which may have been too low. Both mu wife and daughter have problems with extremely dry eyes. I have followed their treatment. I’ll ask about the cholesterol thing.

[JKPrime]

Yes his ldl-c was under control presumably due to some statin therapy. What was not under control was high triglycerides level and low levels of hdl-c at 37 mg/dl. He was also obese. As we know tg to hdl ratio is a substantially better predictor of cv risk ( 1.8 vs 1.3 hazard risk ratio) than ldl-c is.

[Gregg_Bronson]

Exactly! low LDL does not mean you are safe from heart attack or stroke. Remnant cholesterol is what we should be looking at as an indication.

[Gregg_Bronson]

I would venture to guess that Mr Russets remnant cholesterol was very high.

[Jerry_Cahill]

Thank you. I did not know about remnant. Mine is 12 so I think that is good.