Longitudinal Blood Pressure Patterns From Mid- to Late Life and Late-Life Hearing Loss in the Atherosclerosis Risk in Communities Study

J Gerontol A Biol Sci Med Sci. 2022 Mar 3;77(3):640-646. doi: 10.1093/gerona/glab153.

Abstract

Background: Hearing loss is prevalent and associated with adverse functional outcomes in older adults. Prevention thus has far-reaching implications, yet few modifiable risk factors have been identified. Hypertension may contribute to age-related hearing loss, but epidemiologic evidence is mixed. We studied a prospective cohort of 3343 individuals from the Atherosclerosis Risk in Communities study, aged 44-65 years at baseline with up to 30 years of follow-up.

Methods: Hearing was assessed in late life (2016-2017) using a better-ear audiometric pure tone average (0.5, 1, 2, 4 kHz) and the Quick Speech-in-Noise (QuickSIN) test. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or antihypertensive medication use. Midlife hypertension was defined by hypertension at 2 consecutive visits between 1987-1989 and 1996-1998. Late-life hypertension was defined in 2016-2017. Late-life low blood pressure was defined as a systolic blood pressure less than 90 mmHg or diastolic blood pressure less than 60 mmHg, irrespective of antihypertensive medication use. Associations between blood pressure patterns from mid- to late life and hearing outcomes were assessed using multivariable-adjusted linear regression.

Results: Compared to persistent normotension, persistent hypertension from mid- to late life was associated with worse central auditory processing (difference in QuickSIN score = -0.66 points, 95% CI: -1.14, -0.17) but not with audiometric hearing.

Conclusions: Participants with persistent hypertension had poorer late-life central auditory processing. These findings suggest that hypertension may be more strongly related to hearing-related changes in the brain than in the cochlea.

Keywords: Cardiovascular; Epidemiology; Risk factors; Sensory.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Antihypertensive Agents / therapeutic use
  • Atherosclerosis* / complications
  • Atherosclerosis* / epidemiology
  • Blood Pressure
  • Hearing Loss* / complications
  • Hearing Loss* / epidemiology
  • Humans
  • Hypertension* / complications
  • Prospective Studies

Substances

  • Antihypertensive Agents