Statins Raise Glaucoma Risk
Widely prescribed statin drugs come with a hidden risk for glaucoma, along with other side effects. Learn about non-pharmaceutical ways to keep your heart healthy.
STORY AT-A-GLANCE
Research indicates statin use is associated with a 13% increased risk of glaucoma, with a greater risk for those aged 60 to 69
Studies suggest that longer-term statin use (over three years) poses an increased risk for developing glaucoma compared to shorter durations of use
Beyond glaucoma, statins have been linked to other side effects, including muscle pain (myopathy), an increased risk of Type 2 diabetes, cataracts, neurological issues and CoQ10 depletion
Cholesterol plays essential roles in your body, such as building cell membranes and producing hormones; focusing on optimizing cholesterol levels rather than solely lowering them is important for overall health
A comprehensive approach to heart health, including dietary changes, regular exercise, stress reduction and addressing root causes like insulin resistance, is a beneficial long-term strategy
Glaucoma is a serious eye condition that damages your optic nerve, the connection between your eye and your brain. This damage leads to irreversible vision loss and even blindness. Often, glaucoma is linked to increased pressure inside your eye, known as intraocular pressure (IOP).
This pressure harms the delicate nerve fibers of your optic nerve. Think of the optic nerve like a cable carrying visual information to your brain; if that cable is damaged, the signal gets lost, resulting in vision problems. There are different types of glaucoma, but the most common is open-angle glaucoma.
This type often develops slowly and painlessly, with no noticeable symptoms in the early stages. This makes it particularly dangerous, as people may not realize they have it until significant vision loss has occurred. Other, less common types of glaucoma exist, but open-angle glaucoma accounts for the vast majority of cases.
Several factors increase your risk of developing glaucoma. These include age (being older increases your risk), family history of glaucoma, certain ethnicities and high IOP. Now, research has revealed another risk factor: the use of statin medications.
The Link Between Statins and Glaucoma
Statins are a widely prescribed class of medications used to lower cholesterol levels in the blood. They work by blocking an enzyme in your liver that's responsible for producing cholesterol. Recent research uncovered a link between statin use and an increased risk of developing glaucoma.
A 2024 study published in Ophthalmology Glaucoma examined data from the All of Us (AoU) Research Program, a large-scale research effort aimed at understanding health and disease.1 This study looked at 79,742 adults aged 40 and older who had high cholesterol (hyperlipidemia) and available electronic health record (EHR) data. The researchers analyzed the relationship between statin use and the occurrence of glaucoma within this group.
The AoU study found a notable association between statin use and an increased likelihood of having glaucoma.2 Specifically, they found that statin users had a 13% higher chance of having glaucoma compared to those who did not use statins, after adjusting for confounding variables.
The researchers also looked at how cholesterol levels and age play a role in this association.3 They found that the link between statin use and glaucoma was stronger in people with optimal or high low-density lipoprotein (LDL) cholesterol levels.
Those with optimal LDL who used statins had a 39% increased likelihood of glaucoma and those with high LDL had a 37% increased likelihood. Additionally, they found a stronger association in people aged 60 to 69, with a 28% increased likelihood of glaucoma for statin users in this age group. This indicates that age may be a factor in the risk associated with statin use and glaucoma.
Statin Use Duration and Glaucoma Risk
A key question in the statin-glaucoma connection is whether the duration of statin use plays a role. A 2023 study published in Scientific Reports investigated this using a large Japanese claims database.4 This study specifically looked at the relationship between statin use and open-angle glaucoma in Japanese patients with high cholesterol. The researchers used a nested case-control study design, comparing individuals who developed OAG with matched controls who did not.
The study examined statin exposure over two different timeframes: 12 months (Model 1) and 24 months (Model 2) prior to the diagnosis of OAG.5 The researchers found no significant association between statin use and the development of OAG in either model. However, other studies have suggested that longer-term statin use is associated with an increased risk of glaucoma.
For instance, a 10-year cohort study conducted in Australia investigated the long-term effects of statin use on glaucoma onset.6 This study used data from a large cohort of Australians aged over 45 and examined medication use through pharmaceutical claims records between 2009 and 2016.
This research differed from the previously discussed Japanese study by focusing on a longer follow-up period and a different population. The researchers defined glaucoma onset as three or more claims for anti-glaucoma medications.
They then compared these individuals with matched controls who had not been prescribed such medications. The study found that while overall statin use was not significantly associated with glaucoma onset, a different picture emerged when looking at the duration of use.
Specifically, the Australian study found that individuals who had used statins for more than three years had a 12% higher risk of developing glaucoma compared to those who had used them for less than one year.7 This finding suggests that the risk of glaucoma associated with statins may become more apparent with longer-term use.
Regular eye exams are important for detecting glaucoma early. Because the early stages of open-angle glaucoma are often symptom-free, a comprehensive eye exam is the best way to catch it before significant damage occurs.
During an exam, an eye doctor measures your IOP, examines your optic nerve and performs other tests to assess your eye health. Early detection is key to managing glaucoma and preserving your vision, however avoiding unnecessary statin usage is also important.
A Broader Look at Statin Risks
While this article focuses primarily on the link between statins and glaucoma, it's important to acknowledge other side effects associated with these medications. Some individuals taking statins experience muscle pain or weakness, a condition known as myopathy. These muscular issues are thought to stem from mitochondrial dysfunction and alterations in muscle protein metabolism.
Statins are also linked to an increased risk of Type 2 diabetes, cataracts, neurological issues and CoQ10 depletion. For instance, a 2024 Lancet study confirmed that statins increase diabetes risk, with high-intensity statins raising the risk by 36%.8
Further, statins increase cataract risk by interfering with cholesterol biosynthesis in the lens epithelium. One study found that 1.9% of patients underwent cataract surgery during a three-year follow-up period.9
Notably, rosuvastatin was associated with a 1% higher incidence of cataract surgery compared to atorvastatin, likely due to its greater LDL cholesterol-lowering capacity. This suggests that more potent statins like rosuvastatin carry an increased risk of cataract formation.
In addition, statins are associated with an increased risk of hemorrhagic stroke,10 while research published in Scientific Reports also found a significant association between long-term use of anticholesterol drugs (primarily statins) and an increased risk of pancreatic cancer.11 This effect was particularly pronounced in individuals who had been using these drugs for more than five years.
Further, as mentioned, statin use depletes CoQ10, so, for individuals taking statins, supplementing with CoQ10 or its more bioavailable form, ubiquinol, is important. The recommended dosage varies from 100 to 200 milligrams (mg) daily for statin users to 30 mg to 1,200 mg for others, depending on health status and lifestyle factors. Consult with your health care provider to determine the appropriate dosage.
Cholesterol Is Your Body's Essential Building Block
Before deciding to take statin drugs to lower cholesterol, it's important to understand that cholesterol is actually a very important substance in your body. Think of cholesterol like tiny building blocks. They help form the walls of your cells, keeping them strong and flexible.
Cholesterol also helps make hormones your body needs, and it even plays a role in creating vitamin D from sunlight, which keeps your bones strong and your immune system healthy. In your gut, cholesterol helps make bile acids. These are like little helpers that absorb fats and fat-soluble vitamins from your food. Plus, cholesterol is important for creating a protective sheath around your nerves, which helps them send signals quickly throughout your body.
Having the right amount of cholesterol is essential for good health, especially as you age.12 Instead of just trying to lower your cholesterol as much as possible, it's better to focus on keeping your levels in a healthy range. Further, heart disease often occurs when the lining of your arteries gets damaged by unhealthy food, smoking, pollution and stress.
When this happens, your body sends cholesterol to help repair the damage. So, cholesterol is often found in areas where arteries are damaged — it's actually there to help heal, not cause harm.13 Remember, the goal is overall health, not achieving a particular number on a test result. That said, you get a more accurate idea of your risk of heart disease with the following tests:
Omega-3 index
HDL/total cholesterol ratio
Fasting insulin level
Fasting blood sugar level
Triglyceride/HDL ratio
Iron level
How to Protect Your Heart Naturally
While statins are primarily prescribed to lower LDL cholesterol, some experts argue that insulin resistance, not high LDL, is the primary driver of atherosclerosis, which underlies many heart diseases. Insulin resistance leads to a decline in your mitochondrial energy production, and this poor mitochondrial health underlies heart disease and many other chronic conditions.
Dietary factors, particularly the excessive consumption of linoleic acid (LA) in seed oils, are also intricately involved. The primary reason why excess LA is harmful to your health is because it disrupts your mitochondria — the tiny energy factories in your cells that produce adenosine triphosphate (ATP), the essential fuel that keeps your cells running and repairing themselves.
Without energy, your cells can't repair and regenerate themselves. So, the fundamental issue underlying most chronic disease is that your cells are not producing enough energy.
In addition to LA, exposure to synthetic endocrine-disrupting chemicals (EDCs), estrogen and pervasive electromagnetic fields (EMFs) also impair your cells' ability to generate energy efficiently. This energy deficit makes it challenging to sustain the oxygen-free gut environment necessary for beneficial bacteria like Akkermansia to flourish.
Meanwhile, your gut microbiome significantly impacts cholesterol levels, but a lack of cellular energy creates an environment in your gut that favors endotoxin-producing bacteria, further damaging mitochondria, triggering insulin resistance and creating a vicious cycle of worsening health.
By tackling the "Four E's" — excess LA, estrogens (xenoestrogens found in everyday items like plastic), EMFs and endotoxins — you restore your cellular energy and start down the path toward optimal health.
Additionally, ensure you get quality sleep and effectively manage stress, as both play significant roles in your cardiovascular health. Getting regular sun exposure is another foundational aspect of health, but avoid high-intensity sun exposure until you've been off seed oils for about six months, as these oils significantly raise your risk of sunburn.
Avoiding a sedentary lifestyle is equally important. Simple activities like taking regular walks significantly enhance your health, supporting not only your heart but your entire body's functionality. Incorporating these movements helps maintain flexibility, improve circulation and reduce your risk of chronic diseases.
This integrated strategy not only promotes a healthier heart but also allows you to live a longer, healthier life without relying on pharmaceutical interventions like statins.
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As a pharmacist, I have known this for years, but now when I’m asked to take Rosuvastatin for LDL at 130-135, I just won’t do it, especially after reading this study!!
STATINS ARE BAD…