Yévenes-Briones Humberto, Caballero Francisco Félix, Struijk Ellen A, Estrada-deLeón Daniela B, Rey-Martinez Jorge, Rodríguez-Artalejo Fernando, Banegas José R, Lopez-Garcia Esther
Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
Osakidetza Basque Health Service, Biodonostia Health Research Institute, San Sebástian-Donostia, Spain.
Otolaryngol Head Neck Surg. 2024 Jun;170(6):1712-1722. doi: 10.1002/ohn.725. Epub 2024 Mar 17.
To examine the association between hearing function, assessed with pure-tone average (PTA) of air conduction thresholds, and 24-hour ambulatory blood pressure (BP) in older adults.
Cross-sectional study.
A total of 1404 community-dwelling individuals aged ≥65 years from the Seniors-ENRICA cohort were examined.
Hearing loss was defined as PTA > 40-AudCal hearing loss decibels (dB-aHL) in the better ear for standard frequency (0.5, 1, and 2 kHz), speech frequency (0.5, 1, 2, and 4 kHz), and high frequency (3, 4, and 8 kHz). Circadian BP patterns were calculated as the percentage decline in systolic BP during the night, and participants were classified as dipper, nondipper, and riser. Ambulatory hypertension was defined as BP ≥ 130/80 mm Hg (24 hour), ≥135/85 (daytime), and ≥120/70 (nighttime) or on antihypertensive treatment. Analyses were performed with linear- and logistic-regression models adjusted for the main confounders.
In multivariable analyses, the PTA was associated with higher nighttime systolic BP [β coefficient per 20 dB-aHL increment standard frequency (95% confidence interval, CI): 2.41 mm Hg (0.87, 3.95); β (95% CI) per 20 dB-aHL increment speech frequency 2.17 mm Hg (0.70, 3.64)]. Among hypertensive patients, hearing loss at standard and high-frequency PTA was associated with the riser BP pattern [odds ratio: 2.01 (95% CI, 1.03-3.93) and 1.45 (1.00-2.09), respectively]; also, hearing loss at standard PTA was linked to uncontrolled nighttime BP [1.81 (1.01-3.24)].
PTA was associated with higher nighttime BP, and hearing loss with a riser BP pattern and uncontrolled BP in older hypertensives.
研究采用气导阈值纯音平均（PTA）评估的听力功能与老年人24小时动态血压（BP）之间的关联。
横断面研究。
对来自老年人-ENRICA队列的1404名年龄≥65岁的社区居住个体进行了检查。
听力损失定义为较好耳在标准频率（0.5、1和2千赫）、言语频率（0.5、1、2和4千赫）以及高频（3、4和8千赫）时的PTA＞40-听觉校准听力损失分贝（dB-aHL）。昼夜血压模式计算为夜间收缩压的下降百分比，参与者被分为勺型、非勺型和上升型。动态高血压定义为血压≥130/80毫米汞柱（24小时）、≥135/85（白天）和≥120/70（夜间）或正在接受降压治疗。采用针对主要混杂因素进行调整的线性和逻辑回归模型进行分析。
在多变量分析中，PTA与较高的夜间收缩压相关[标准频率每增加20 dB-aHL的β系数（95%置信区间，CI）：2.41毫米汞柱（0.87，3.95）；言语频率每增加20 dB-aHL的β（95%CI）：2.17毫米汞柱（0.70，3.64）]。在高血压患者中，标准和高频PTA的听力损失与上升型血压模式相关[比值比分别为：2.01（95%CI，1.03 - 3.93）和1.45（1.00 - 2.09）]；此外，标准PTA的听力损失与夜间血压未得到控制相关[1.81（1.01 - 3.24）]。
PTA与较高的夜间血压相关，听力损失与老年高血压患者的上升型血压模式及血压未得到控制相关。
