ACE inhibitor use not associated with materially altered risk of cataract

  • Becker C & al.
  • Br J Ophthalmol
  • 7 Feb 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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  • This large observational study suggests that exposure to angiotensin-converting enzyme inhibitors (ACEIs) is not associated with an altered risk for cataract.

Why this matters

  • ACEIs showed beneficial effects on cataract development in experimental studies which stand in contrast to the results of a previous observational study, which reported an increased risk for cataract with ACEIs use.
  • To date, there is very little evidence to prove that ACEIs use is associated with the risk of cataract.

Study design

  • This case-control study evaluated 206,931 cataract cases (age ≥40 years) and equal numbers of matched controls using data from the UK-based Clinical Practice Research Datalink.
  • The number of prescriptions for ACEI and other antihypertensive drugs were assessed and the use of single ACEI substances was explored.
  • Funding: None disclosed.

Key results

  • Use of ACEI was not associated with increased risk for cataract compared with non-use in the analysis for sequential or concomitant use (adjusted OR [aOR], 1.06; 95% CI, 1.04-1.08).
  • Risk of cataract did not increase with other antihypertensive drug classes:
    • calcium channel blocker (OR, 1.10; 95% CI, 1.08-1.11),
    • beta-blocker (OR, 1.07; 95% CI, 1.05-1.09),
    • angiotensin receptor blocker (OR, 1.12; 95% CI, 1.09-1.15).
  • In the analysis of exclusive use, ACEI users were not at increased risk for cataract compared with non-users of any antihypertensive drugs (aOR 1.13; 95% CI, 1.09-1.16).


  • Possibility of some controls having early undiagnosed cataract during the study period.

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