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Δευτέρα 12 Αυγούστου 2019

Association of Midlife Hypertension with Late-Life Hearing Loss
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Nicholas S. Reed, AuD, Matthew G. Huddle, MD, Joshua Betz, MS, Melinda C. Power, ScD, James S. Pankow, PhD, MPH, Rebecca Gottesman, MD, PhD, A. Richey Sharrett, MD, Thomas H. Mosley, PhD, Frank R. Lin, MD, PhD, Jennifer A. Deal, PhD First Published August 6, 2019 Research Article 
https://doi.org/10.1177/0194599819868145
Article information
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Abstract
Objective
To investigate the association of midlife hypertension with late-life hearing impairment.

Study Design
Data from the Atherosclerosis Risk in Communities study, an ongoing prospective longitudinal population-based study (baseline, 1987-1989).

Setting
Washington County, Maryland, research field site.

Subjects and Methods
Subjects included 248 community-dwelling men and women aged 67 to 89 years in 2013. Systolic blood pressure (SBP) and diastolic blood pressure were measured at each of 5 study visits from 1987-1989 to 2013. Hypertension was defined by elevated systolic or diastolic blood pressure or antihypertensive medication use. A 4-frequency (0.5-4 kHz) better-hearing ear pure tone average in decibels hearing loss (dB HL) was calculated from pure tone audiometry measured in 2013. A cutoff of 40 dB HL was used to indicate clinically significant moderate to severe hearing impairment. Hearing thresholds at 5 frequencies (0.5-8 kHz) were also considered separately.

Results
Forty-seven participants (19%) had hypertension at baseline (1987-1989), as opposed to 183 (74%) in 2013. The SBP association with late-life pure tone average differed by the time of measurement, with SBP measured at earlier visits associated with poorer hearing; the difference in pure tone average per 10–mm Hg SBP measured was 1.43 dB HL (95% CI, 0.32-2.53) at baseline versus −0.43 dB HL (95% CI, −1.41 to 0.55) in 2013. Baseline hypertension was associated with higher thresholds (poorer hearing) at 4 frequencies (1, 2, 4, 8 kHz).

Conclusion
Midlife SBP was associated with poorer hearing measured 25 years later. Further analysis into the longitudinal relationship between hypertension and hearing impairment is warranted.

Keywords hearing loss, hypertension, epidemiology

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