Racial and Ethnic Differences in the Association Between Statin Use and the Risk of Ocular Hypertension and Open-Angle Glaucoma.

Objective: To evaluate the association between statin use and the risk of ocular hypertension (OHT) and open-angle glaucoma (OAG) among patients with hyperlipidemia across different racial and ethnic subgroups.

Methods: Retrospective clinical cohort study. Methods: We used anonymized TriNetX United States Collaborative Network database. Patients aged ≥40 years with hyperlipidemia and at least 4 statin prescriptions were included and stratified into 4 cohorts: non-Hispanic Whites, non-Hispanic African Americans, non-Hispanic Asians, and Hispanics. Propensity score matching (PSM) was performed separately for each cohort to minimize confounding, incorporating demographic, clinical, laboratory, medication, and socioeconomic variables. The primary outcomes were the development of OHT or OAG at 1- and 5-years postindex date, analyzed using multivariate Cox proportional hazard models.

Results: A total of 309 255 patients were analyzed. After PSM, statin use was significantly associated with a reduced risk of OHT and OAG among non-Hispanic Whites at 1 and 5 years (P < .0001). Adjusted hazard ratio (aHR) for OHT was 0.5 (95% confidence interval (CI): 0.4-0.6) at 1 year and remained at 0.5 (95% CI: 0.5-0.6) at 5 years, while the aHR for OAG was 0.7 (95% CI: 0.6-0.7) at 1 year and 0.6 (95% CI: 0.5-0.6) at 5 years. Among non-Hispanic African Americans, statin use was associated with a reduction in OAG risk at both time points (P < .0001), with an aHR of 0.8 (95% CI: 0.6-0.9) at 1 year and 0.6 (95% CI: 0.5-0.7) at 5 years, but no significant effect on OHT risk. In non-Hispanic Asians, statin use did not significantly reduce the risk of OHT or OAG at 1 year, though a reduction in OAG risk was observed by 5 years (aHR: 0.7, 95% CI: 0.5-0.9, P = .007). Similarly, in the Hispanic cohort, statin use did not affect OHT or OAG risk at 1 year but was associated with a lower risk of OAG at 5 years (aHR: 0.7, 95% CI: 0.6-0.8, P = .0003).

Conclusions: Statin use was associated with a reduced risk of OHT and/or OAG in most racial and ethnic groups, with differences in timing and magnitude of effects. These findings underscore the importance of exploring mechanisms underlying racial disparities in outcomes.