Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Cochlear Center on Hearing and Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Otolaryngol Head Neck Surg. 2019 Dec;161(6):996-1003. doi: 10.1177/0194599819868145. Epub 2019 Aug 6.
To investigate the association of midlife hypertension with late-life hearing impairment.
Data from the Atherosclerosis Risk in Communities study, an ongoing prospective longitudinal population-based study (baseline, 1987-1989).
Washington County, Maryland, research field site.
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.
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).
Midlife SBP was associated with poorer hearing measured 25 years later. Further analysis into the longitudinal relationship between hypertension and hearing impairment is warranted.
研究中年高血压与老年听力障碍的关系。
数据来自于动脉粥样硬化风险社区研究，这是一项正在进行的前瞻性纵向人群基础研究（基线，1987-1989 年）。
马里兰州华盛顿县，研究现场。
2013 年，受试者包括 248 名年龄在 67 至 89 岁之间的社区居住的男性和女性。1987-1989 年至 2013 年的 5 次研究访视中分别测量了收缩压（SBP）和舒张压。高血压的定义为收缩压或舒张压升高或使用抗高血压药物。从 2013 年测量的纯音测听中计算出 4 个频率（0.5-4 kHz）较好耳朵的纯音平均听力损失（dB HL）。40 dB HL 的临界值用于表示临床上明显的中度至重度听力障碍。还分别考虑了 5 个频率（0.5-8 kHz）的听力阈值。
47 名参与者（19%）在基线时（1987-1989 年）患有高血压，而 2013 年时为 183 名（74%）。与 2013 年相比，SBP 与老年纯音平均的相关性因测量时间而异，较早的访视中 SBP 与听力较差有关；在基线时，每 10mmHg SBP 测量的纯音平均差值为 1.43dB HL（95%CI，0.32-2.53），而在 2013 年时为-0.43dB HL（95%CI，-1.41 至 0.55）。基线时的高血压与 4 个频率（1、2、4、8 kHz）的较高阈值（听力较差）有关。
中年 SBP 与 25 年后较差的听力有关。有必要进一步分析高血压与听力障碍之间的纵向关系。
