Hormone Replacement Therapy in Relation to Risk of Cataract Extraction: A Prospective Study of Women
Received 5 March 2009; received in revised form 11 June 2009; accepted 10 July 2009. published online 04 January 2010.
Objective
To investigate the association between hormone replacement therapy (HRT) and the incidence of cataract extraction among postmenopausal women.
Design
Population-based, prospective cohort study.
Participants
A total of 30 861 postmenopausal women participating in the Swedish Mammography Cohort, age 49 to 83 years, who completed a self-administered questionnaire in 1997 about hormone status, HRT, and lifestyle factors.
Methods
The women were followed from September 1997 through October 2005. The cohort was matched with registers of cataract extraction in the study area.
Main Outcome Measures
Incident operative extraction of age-related cataract.
Results
We identified 4324 incident cases of cataract extractions during 98 months of follow-up. In multivariate adjusted analysis, ever use of HRT was associated with a 14% increased risk of cataract extraction (rate ratio [RR], 1.14; 95% confidence interval [CI], 1.07–1.21) compared with those who never used HRT. Current use of HRT was associated with an 18% increased risk of cataract extraction (RR, 1.18; 95% CI, 1.10–1.26). A significant linear trend was observed where increasing duration of HRT usage resulted in an increased risk of cataract extraction (P for trend = 0.006). Multivariate RR for current HRT usage for >10 years was 1.20 (95% CI, 1.06–1.36; P for trend = 0.001). Among women drinking on average >1 drink of alcohol per day, current HRT users had a 42% increased risk (RR, 1.42; 95% CI, 1.11–1.80) for cataract extraction, compared with women who neither used HRT nor alcohol. The risk of cataract extraction among current users of HRT was similar among current smokers and those who never smoked.
Conclusions
Our prospective, population-based study indicates that postmenopausal women using HRT for a long period of time may be at an increased risk for cataract extraction, especially those drinking >1 alcoholic drink daily.
Financial Disclosure(s)
The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Available online: January 4, 2010.
1Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
2Department of Ophthalmology, Sundsvall Hospital, Sundsvall, Sweden
3Stockholm Eye Clinic, H.M. Queen Sophia Hospital, Stockholm, Sweden
Correspondence: Birgitta Ejdervik Lindblad, MD, Department of Ophthalmology, Sundsvall Hospital, SE-851 86 Sundsvall, Sweden
Manuscript no. 2009-317.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.
Supported by grants from the Swedish Research Council/Medicine, Stockholm, Sweden; Swedish Council for Working Life and Social Research, Stockholm, Sweden; Crown Princess Margaret's Foundation, Stockholm, Sweden; Carmen and Bertil Regnér Foundation, Stockholm, Sweden; Synfrämjandet in Stockholm, Sweden and Västernorrland County Council, Sundsvall, Sweden. The Swedish Research Council/Committee for infrastructure, Stockholm, Sweden, contributed to the maintenance of the cohort.
ABSTRACT