Abstract
The contribution of hypertension to hearing impairment (HI) in older adults is poorly understood. Hypertension could plausibly contribute to impaired circulation in the cochlea and thereby disrupt metabolic activity related to hearing. However, results from previous epidemiologic studies of the association of hypertension and hearing loss have been inconsistent, and the relative importance of midlife versus late-life hypertension is unknown. We analyzed data from 248 men and women (45–64 years at baseline, 1987–1989) in the Atherosclerosis Risk in Communities (ARIC) Study to quantify the relationship of mid- and late-life hypertension with late-life HI. Blood pressure was measured over5 visits that were interspersed from 1997–2013. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure (DBP) ≥90 mmHg, or antihypertensive use. SBP and DBP were also modeled continuously. Hearing was assessed using pure tone audiometry in 2013. A better-hearing ear pure-tone average (PTA) in decibels hearing level (db HL) was calculated using thresholds from 0.5–4 kHz and modeled continuously The difference in PTA associated with hypertension was estimated using multivariable linear regression. 47 participants (19%) had hypertension at Visit 1(1987–89) compared to 183 (74%) at Visit 5(2013). In analyses adjusted for demographic and clinical covariates, midlife SBP was associated with HI, but late-life SBP was not (difference in PTA per 10mm Hg SBP measured at Visit 1(1987–89): 1.43 dB HL (95% CI: 0.32,2.53) vs. Visit 5(2013): -0.43 dB HL (95%CI: -1.41,0.55). Our results demonstrate that midlife, but not late-life, SBP was independently associated with poorer hearing.