Audiometric pattern as a predictor of cardiovascular status: Development of a model for assessment of risk

Abstract

Audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease and may represent a screening test for those at risk. Patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.

White Matter Hyperintensities Predict Low Frequency Hearing in Older Adults

“…In addition, older gerbils raised without exposure to noise or ototoxic drugs exhibit stria vascularis atrophy with pronounced capillary loss and a reduction in the endocochlear potential, which provides the voltage to the outer hair cells (cochlear amplifier) (Johnsson and Hawkins 1972;Pauler et al 1988;Schulte and Schmiedt 1992;Gratton et al 1996Gratton et al , 1997Thomopoulos et al 1997). Consistent with evidence for vessel disease affecting the stria vascularis, as well as the spiral ganglion (Makishima 1978), there is cross-sectional evidence that cardiovascular risk factors and vascular events are correlated with agerelated hearing loss (Susmano and Rosenbush 1988;Perez Villa et al 1995;Brant et al 1996;Friedland et al 2009). …”

“…In support of this premise, sclerosis of the internal auditory artery and circle of Willis was observed in a post-mortem examination of tissue from people who had age-related hearing loss and high blood pressure (Makishima 1978). In addition, a retrospective study of audiograms in patients with histories of vascular events demonstrated that people with flat and low sloping audiograms were significantly more likely to have had a cerebrovascular event than people with other audiometric profiles (Friedland et al 2009). …”

“…We examined the extent to which hearing acuity was associated with vessel disease in groups with and without a reported history of high blood pressure because of evidence for cerebrovascular events relating to an audiometric configuration in cardiac patients (Friedland et al 2009). We reasoned that individual variation in the severity of vessel disease could produce individual differences in WMH and hearing.…”

A Prospective Study of Cardiovascular Risk Factors and Incident Hearing Loss in Men

“…Several studies have described microvascular disease as a possible mechanism for agerelated hearing loss 6,15 . This is the first large prospective epidemiologic human study of the association between cardiovascular risk factors and hearing loss.…”

“…Specifically, the vascular nature of the stria vascularis may make it especially vulnerable to vascular compromise 6 . Strial presbycusis, a distinct class of age-related hearing loss described by Schuknecht 7,8 , has been shown in cross-sectional analyses to be significantly associated with incident cardiovascular disease, with a demonstrated increased risk of stroke, coronary artery disease and myocardial infarction in individuals with this condition 6 . Nationally representative prevalence data have also indicated an increased prevalence of hearing loss in individuals with a history of hypertension, diabetes mellitus or smoking 2 .…”