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There’s a Link between Cardiovascular Disease and Hearing Loss!

The previous Hearing Health article discussed the consequences of untreated hearing loss. The takeaway was simple…there are consequences for everything we do…or don’t do! This article discusses the link between hearing loss and cardiovascular disease. Getting a baseline hearing exam is more important than you may have thought.

Introduction: A growing body of research is showing a significant correlation between cardiovascular disease and low-frequency hearing loss. These studies 1) underscore the advantage of obtaining a baseline hearing exam and, 2) indicate a growing need for Audiologists and Physicians to work in partnership for the best health outcome of patients.

Early Studies: Most of the early studies focus on the consequences of decreased blood supply due to cardiovascular disease, and the resulting negative effects on the blood vessel health of the inner ear. The inner ear is studied because it is loaded with blood vessels and extremely sensitive to blood supply, so abnormalities show up here before they can be found elsewhere. These studies indicate that a healthy cardiovascular system promotes healthy hearing, but inadequate blood supply and resulting damage to the blood vessels of the inner ear can contribute to hearing loss.

New Research: A two-part study, Audiometric Pattern as a Predictor of Cardiovascular Status: Development of a Model for Assessment of Risk, suggests that low-frequency hearing loss could be a marker for cardiovascular disease rather than a result of the disease. This study also indicates that low-frequency audiometric patterns (observed on sensitive audiological equipment) can be used to determine the probability and risk for cardiovascular events and cerebrovascular disease such as stroke and transient ischemic attacks (compromised blood supply in the brain). An underlying premise of the study is that vascular aspects (decreased blood supply) of cardiovascular disease show up as abnormalities in the condition of inner ear blood supply before they are revealed in the heart, brain, arteries, kidneys, or eyes, due to the inner ear’s extreme sensitivity to blood supply.

Key findings in this study indicate that low-frequency hearing loss could be an early indicator of cerebrovascular disease (an indicator of stroke potential) or a predictor for ongoing or developing cardiovascular disease. Findings were presented in 2009 at a Combined Otolaryngology Spring Meeting by David R. Friedland, MD, PhD. and published in The Laryngoscope (119:473-486, 2009).

Dr. Friedland summed up the important potential application of the study: “We propose that low-frequency hearing loss is a marker for cardiovascular disease rather than the other way around. Low-frequency hearing loss would thus represent a potential predictor of impending cardiovascular events or underlying disease. We suggest that clinicians may use the audiogram as a sensitive and reproducible screen for cardiovascular compromise”.

Conclusions: Considering the strength of the evidence, researchers conclude that patients with an audiogram pattern of low-frequency hearing loss present a higher risk for cardiovascular events, and that appropriate referrals may be necessary, especially if they have NO history of vascular disease.

Audiologists commonly refer patients to Physicians when they suspect medical problems. These studies (and others) should promote a call to action for physicians to refer more patients to Audiologists when they suspect hearing loss. Many Audiologists have Doctor of Audiology (AuD) credentials, significant medical knowledge, and the advanced diagnostic equipment necessary to uncover the potential for underlying medical conditions. In any case, these and other studies suggest an increasing role for Audiologists to support the overall health of patients.

About the Author: Dr. Ha-Sheng Li-Korotky is the President and co-founder of Pacific Northwest Audiology (www.pnwaudiology.com), based in Bend, Oregon (see back inside cover). The Doctor is a nationally acclaimed clinician and research scientist, with AuD, PhD, and MD credentials and more than 100 scientific publications.

A Link Between Hearing Loss and Cardiovascular Disease – Bend Residents Should Get a Baseline Hearing Exam.

A growing body of research is showing a solid connection between decreased blood flow from cardiovascular disease and low frequency hearing loss. Reduced blood flow in the body can cause the restriction of blood flow in the inner ear, causing irreversible damage and low frequency hearing loss. The pattern of this hearing loss can be seen in hearing tests …thus the connection between cardiovascular disease and audiometric patterns.

The following figure illustrates the proposed relationship between cardiovascular disease and low-frequency hearing loss. For this model…cardiovascular disease leads to low frequency hearing loss.

 

Key findings in a two-part study investigating whether there is a relationship between audiometric patterns and vascular disease indicate that low-frequency hearing loss could be an early indicator that a patient has cerebrovascular disease or is at risk for cardiovascular disease. Findings were presented in 2009 at a Combined Otolaryngology Spring Meeting by David R. Friedland, MD, PhD.

Dr. Friedman summed up the important potential application of the study: “We propose that low frequency hearing loss is a marker for cardiovascular disease rather than the other way around. Low-frequency hearing loss would thus represent a potential predictor of impending cardiovascular events or underlying disease. We suggest that clinicians may use the audiogram as a sensitive and reproducible screen for cardiovascular compromise”.

The following figure illustrates a predictive relationship between a low-frequency hearing loss pattern and cardiovascular disease. For this model…a low frequency hearing loss audiometric pattern may be an early marker for cardiovascular disease.

 

The following adaptation from a Better Hearing Institute’s (BHI) article summarizes the findings from this and other studies on the subject.

Considering the growing evidence, we recommend you get a baseline hearing test from a qualified Audiologist…especially if you are being treated for cardiovascular disease. Changes in your hearing can be measured against this baseline over time.

The Connection between Heart and Hearing Health

The inner ear is extremely sensitive to blood flow. Studies have shown that a healthy cardiovascular system—a person’s heart, arteries, and veins—has a positive effect on hearing. Conversely, inadequate blood flow and trauma to the blood vessels of the inner ear can contribute to hearing loss.

Some researchers hypothesize that because the inner ear is so sensitive to blood flow, abnormalities in the condition of blood vessels here could be noted earlier than in other, less sensitive parts of the body.

In one study, published in The Laryngoscope, researchers hypothesized that low-frequency hearing loss is associated with underlying cardiovascular disease; and a mathematical formula using audiometric pattern and medical history to predict the probability of cardiovascular diseases and events was developed and tested. The researchers concluded that the audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease, and that it may represent a screening test for those at risk. The researchers also concluded that patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and that appropriate referrals should be considered.

In another study, published in the June 2011 issue of the Journal of the American Geriatrics Society, researchers looked at hearing sensitivity in older adults and its association with cardiovascular risk factors. They concluded that modifiable risk factors for cardiovascular disease may play a role in the development of age-related hearing loss. Risk factors associated with poorer hearing sensitivity in men included high triglyceride levels, high resting heart rate, and a history of smoking. In women, poor hearing sensitivity was associated with high body mass index, high resting heart rate, fast aortic pulse-wave velocity (PWV), and low ankle–arm index (AAI).

In still another study, published in the June 2010 issue of the American Journal of Audiology, the authors reviewed research that had been conducted over the past 60 plus years. They found that the negative influence of impaired cardiovascular health on both the peripheral and central auditory system, and the potential positive influence of improved cardiovascular health on these same systems, was found through a sizable body of research.

The bottom line

  • A growing body of research is showing strong relationships between hearing loss and a wide spectrum of underlying medical conditions. These studies underscore a growing necessity for PCP Doctors to develop professional partnerships with AuD-level Audiologists for better serving the total needs of patients.
  • Audiologists have the specialized equipment and training necessary to uncover the potential for an increasing number of underlying medical conditions, and early detection/treatment by both physicians and Audiologists will promote a patient’s best chance of recovery.
  • And…people with heart disease should get their hearing checked because of the link between cardiovascular disease and hearing health.