Associations Between Statin Use and Glaucoma in the All of Us Research Program

Purpose To investigate associations between statin use and glaucoma in the 2017-2022 All of Us (AoU) Research Program. Design Cross-sectional, population-based. Participants 79,742 adult participants aged ≥ 40 years with hyperlipidemia and with electronic health record (EHR) data in the AoU database. Methods Hyperlipidemia, glaucoma status, and statin use were defined by diagnoses and medication information in EHR data collected by AoU. Logistic regression analysis was performed to evaluate the association between statin use and glaucoma likelihood. Logistic regression modeling was used to examine associations between glaucoma and all covariates included in adjusted analysis. Serum low-density lipoprotein cholesterol (LDL-C) was used to assess hyperlipidemia severity. Analyses stratified by LDL-C level and age were performed. Main Outcome Measures Any glaucoma as defined by International Classification of Diseases (ICD) codes found in EHR data. Results Of 79,742 individuals with hyperlipidemia in AoU, there were 6,365 (8.0%) statin users. Statin use was associated with increased glaucoma prevalence when compared with statin non-use (adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 1.01-1.26). Higher serum levels of LDL-C were associated with increased odds of glaucoma (aOR: 1.003, 95% CI: 1.003, 1.004). Statin users had significantly higher LDL-C levels compared to nonusers (144.9 mg/dL versus 136.3 mg/dL, p-value < 0.001). Analysis stratified by LDL-C identified positive associations between statin use and prevalence of glaucoma among those with optimal (aOR = 1.39, 95% CI = 1.05-1.82) and high (aOR = 1.37, 95% CI = 1.09-1.70) LDL-C levels. Age-stratified analysis showed a positive association between statin use and prevalence of glaucoma in individuals aged 60-69 years (aOR = 1.28, 95% CI = 1.05-1.56). Conclusions Statin use was associated with increased glaucoma likelihood in the overall adult AoU population with hyperlipidemia, in individuals with optimal or high LDL-C levels, and in individuals 60-69 years old. Findings suggest that statin use may be an independent risk factor for glaucoma, which may furthermore be affected by one’s lipid profile and age.