Ask Dr. H: Hypertension drugs, cataract risk

Question:

A recent British study said Monopril (fosinopril) antihypertensive medication causes cataracts. Could you comment on that?

Answer: I'm not sure if I'm referring to the same study you're describing, but a recent article from the University of Sydney, Australia, published in the British Journal of Ophthalmology described a link between the use of beta blockers and ACE inhibitors (Monopril is a member of this class of drugs) for hypertension and the formation of cataracts. In their study, researchers cite a 54 percent relative increased risk of cataract surgery with the use of ACE inhibitor drugs like Monopril.

I find these findings curious, since numerous studies have found ACE inhibitor blood pressure medications like Monopril, lisinopril, and enalapril to be protective of the eyes and protective against free radical damage, and to provide protection against the oxidation that causes cataract formation.

The Sydney researchers, while acknowledging their findings of a higher incidence of cataracts in people who use ACE inhibitors for hypertension, still strongly recommend that ACE inhibitors continue to be used given their proven efficacy in the treatment of hypertension and protection to the kidneys against the effects of longstanding hypertension and diabetes. Their benefits clearly outweigh the risks.

nolead begins

Q:

Since about the first or second week in August, a lot of pharmacies around here have been posting signs that flu shots are available. Isn't that too early? I've always thought late September/early October was the best time. What are you advising your patients?

A: I'm offering flu shots now to my patients. Although in years past, doctors have given flu shots in early fall, the Centers for Disease Control and Prevention recommends getting the vaccine as soon as it becomes available. They say even August is not too early. It should provide at least six to eight months of immunity against the targeted strains of influenza, and that should comfortably get you through the full season, including the peak of flu in your area. Influenza can begin showing up in October, but the peak of influenza will vary from region to region.

Keep in mind that although the same three strains of flu virus given during the 2010-11 season were chosen to be used for 2011-12, it is still advised to receive a flu shot this year because immunity from last year's vaccine wanes over time and may not protect you two years in a row.

One last point I make every time I discuss flu shots: While some people may have a flulike reaction after getting a shot, it is impossible to come down with the flu from a flu shot. The vaccine does not contain live flu virus.