title: Prospective study of cataract extraction and risk of coronary heart disease in women.
abstract: Oxidative damage to proteins in the human lens is believed to be important in the etiology of age-related cataract. Because free radical-mediated oxidative damage to lipoproteins may accelerate atherosclerosis, the authors hypothesized that the development of cataract might be a marker for such damage and therefore might be associated with future risk of coronary heart disease (CHD). The authors followed 60,657 women aged 45--63 years and without known coronary disease, stroke, or cancer in 1984. During 10 years of follow-up (674,283 person-years), the authors documented 887 incident cases of CHD and 2,322 deaths. After adjustment for age, smoking, and other coronary risk factors, cataract extraction was significantly associated with higher risk of CHD (relative risk (RR) = 1.88, 95% confidence interval (CI): 1.41, 2.50) for total CHD, 2.44 (95% CI: 1.54, 3.89) for fatal CHD, and 1.63 (95% CI: 1.14, 2.34) for nonfatal myocardial infarction). The positive association between cataract extraction and total CHD was stronger among women with a history of diabetes (RR = 2.80, 95% CI: 1.77, 4.42) than among those without reported diabetes (RR = 1.51, 95 percent CI: 1.04, 2.18). In multivariate analyses, cataract extraction was associated with significantly increased overall mortality (RR = 1.37, 95 percent CI: 1.13, 1.66), which was entirely explained by the increased mortality from cardiovascular disease (RR = 1.84, 95% CI: 1.29, 2.64). These findings are compatible with current hypotheses relating oxidative damage and tissue aging to the development of cataract and CHD.
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA. Frank.Hu@channing.harvard.edu
authors.forename: F B
authors.initials: FB
authors.lastname: Hu
authors.forename: S E
authors.initials: SE
authors.lastname: Hankinson
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: J E
authors.initials: JE
authors.lastname: Manson
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
authors.forename: F E
authors.initials: FE
authors.lastname: Speizer
authors.forename: C H
authors.initials: CH
authors.lastname: Hennekens
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
mesh_terms: D002386:Cataract / Q000453:epidemiology*; D002387:Cataract Extraction / Q000706:statistics & numerical data*; D015897:Comorbidity; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology