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Hearing Loss and Cardiovascular Disease Linked

This article discusses the link between hearing loss and cardiovascular disease, and underscores a growing role for audiologists

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.

Diabetes and Hearing Loss

Introduction

We’ve discussed the links between untreated hearing loss and a variety of debilitating medical and emotional conditions, including dementia, depression, and Alzheimer’s disease. Given the overwhelming evidence…we felt it was important to reveal that untreated hearing loss is more than an inconvenience, but will eventually damage your physical, emotional, and social health, while causing disturbing effects on your relationships with loved ones, family, and friends. This article will discuss the link between diabetes and hearing loss.

The Problem

People with diabetes may have a higher risk of developing hearing problems than those without the disease. This is because sustained high blood glucose levels from uncontrolled diabetes can eventually damage the small blood vessels of the body…resulting in eye, kidney, and nerve diseases. Since hearing depends on these small blood vessels and nerves, researchers are increasingly convinced that diabetes can cause ear damage and hearing loss.

The Evidence

A 2008 study, using National Health and Nutrition Examination Survey results, found a higher prevalence of hearing damage among diabetics (21%) than non-diabetics (9%). The degree of hearing loss ranged from mild to moderate, was generally difficult to detect without a hearing test, but inflicted substantial limitations on communicating. The strongest association between diabetes and hearing loss was noted in younger survey respondents (those less than 60 years old). This is important because hearing loss in this age group is uncommon, suggesting a connection between the diabetes and hearing loss. These findings imply that people with diabetes are much more likely to have hearing problems than those without diabetes, and the increased risk of hearing loss for those with diabetes doesn’t appear to be related to other common causes of hearing damage.

Another study, The Link between Diabetes and Hearing Loss, showed that diabetes affects one in five veterans receiving care at the Veterans Administration. The findings from this study show a link between diabetes, hearing loss and auditory brainstem function, and recommend that patients with diabetes should be screened for hearing loss.

Combining the results of 13 previous studies (including the two referenced above), Japanese researchers found that hearing loss was twice as common among people with diabetes compared to those without, and the effects of older age couldn’t explain the results. The research, published online in the Journal of Clinical Endocrinology & Metabolism, are based on research involving more than 20,000 people from the United States, Asia, Australia and Brazil. All but one study found an association between diabetes and a higher risk of hearing problems. Neither age nor exposure to a noisy workplace could explain the association between diabetes and hearing loss, according to Chika Horikawa, a dietitian at Niigata University in Japan, who led the analysis of the 13 studies.

Still another study, Risk of developing sudden sensorineural hearing loss in diabetic patients: a population-based cohort study, published in Ontology & Neurology in December 2012 and involving more than 52,000 individuals, found that diabetes significantly increases a person’s risk of developing sensorineural hearing loss…a form of hearing loss associated with damage to the inner ear.

Implications

A growing body of research indicates that poor blood sugar control damages blood vessels and nerves throughout the body, and this blood vessel deterioration could explain why people with diabetes (especially younger people less than 60 years old) have more diabetes-related hearing problems than older populations. The research provides strong reasons for people with diabetes and symptoms of hearing loss, especially those under 60, to seek testing and possible treatment.

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. The Doctor is a nationally acclaimed clinician and research scientist, with AuD, PhD, and MD credentials and more than 100 scientific publications.