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Aspirin Use and Risk of Cataract in Posttrial Follow-up of Physicians' Health Study I
Arch Ophthalmol. 2001;119:405-412.
Background In Physicians' Health Study I, randomized trial results indicated no
major beneficial effect of 5 years of low-dose aspirin treatment on total
cataract (relative risk [RR], 0.94; 95% confidence interval [CI], 0.79-1.13)
or cataract extraction (RR, 0.81; 95% CI, 0.65-1.01) during the period of
treatment.
Objective To examine the effect of assigned aspirin treatment and posttrial, self-selected
aspirin use on the risk of age-related cataract over the 15 years of follow-up
of Physicians' Health Study I.
Methods Participants were 20 968 US male physicians enrolled in Physicians'
Health Study I who did not report cataract at baseline. At 7 years, after
termination of the randomized aspirin component of the trial, self-selected
aspirin use was computed from annual questionnaires. The main outcome measures
were age-related cataract and extraction of age-related cataract, defined
as an incident, age-related lens opacity responsible for a reduction in best-corrected
visual acuity to 20/30 or worse based on self-report confirmed by medical
record review.
Results During a median of 14.9 years of follow-up, there were 2081 cataracts
and 1198 cataract extractions. Overall, the age- and beta carotene–adjusted
RR of cataract in men assigned to aspirin compared with those assigned to
placebo was 1.09 (95% CI, 1.00-1.18). For cataract extraction, the RR was
1.09 (95% CI, 0.98-1.22). During a median posttrial follow-up of 7.9 years,
a total of 1225 incident cataracts and 635 cataract extractions were documented.
The multivariate RR of cataract in men who reported using aspirin frequently
( 180 days per year) at 7 years compared with nonusers (0-13 days per year)
was 1.20 (95% CI, 1.03-1.40). For cataract extraction, the multivariate RR
was 1.22 (95% CI, 0.98-1.51). Results for diagnosis and extraction of cataract
subtypes were similar.
Conclusions Analyses based on randomized aspirin assignment indicated no long-term
benefit of 5 years of low-dose aspirin treatment on total cataract or cataract
extraction. Posttrial, observational data also indicated no decreased risk
of cataract in aspirin users and suggested a small increased risk of cataract
in aspirin users. Further randomized trial data to investigate the effect
of longer term treatment with low-dose aspirin are being collected as part
of the ongoing Women's Health Study, a randomized trial of low-dose aspirin
and vitamin E among 39 876 apparently healthy, postmenopausal US female
health professionals.
William G. Christen, ScD;
Umed A. Ajani, MBBS;
Debra A. Schaumberg, ScD;
Robert J. Glynn, ScD;
JoAnn E. Manson, MD;
Charles H. Hennekens, MD
From the Division of Preventive Medicine (Drs Christen, Ajani, Schaumberg,
Glynn, and Manson) and Channing Laboratory (Dr Manson), Department of Medicine,
Harvard Medical School and Brigham and Women's Hospital, Boston, Mass, and
the Departments of Biostatistics (Dr Glynn) and Epidemiology (Dr Manson),
Harvard School of Public Health, Boston. Dr Hennekens is now with the University
of Miami School of Medicine, Miami, Fla.
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