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. 2024 May 7;8(6):igae047.
doi: 10.1093/geroni/igae047. eCollection 2024.

Age-Specific Association Between Visit-to-Visit Blood Pressure Variability and Hearing Loss: A Population-Based Cohort Study

Xinyue Guo  1 , Renjian Sun  2 , Xiaorui Cui  1 , Yahang Liu  1 , Yating Yang  1 , Ruilang Lin  1 , Hui Yang  1 , Jingyi Wu  1 , Jiaqin Xu  1 , Yuwei Peng  1 , Xueying Zheng  1 , Guoyou Qin  1   3 , Jiaohua Chen  2
Affiliations

Age-Specific Association Between Visit-to-Visit Blood Pressure Variability and Hearing Loss: A Population-Based Cohort Study

Xinyue Guo et al. Innov Aging. .

Abstract

Background and objectives: Hearing loss is common and undertreated, and the impact of blood pressure variability (BPV) on the development of hearing loss remains unclear. We aimed to examine the age-specific association between visit-to-visit BPV and hearing loss.

Research design and methods: This nationally representative cohort study included 3,939 adults over 50 years from the Health and Retirement Study in the United States. Variabilities of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by standard deviation (SD), coefficient of variation, and variability independent of the mean (VIM), using SBP and DBP from 3 visits. Hearing loss was assessed by self-rated questions. Cox proportional risk models were used to evaluate age-specific associations (50-64, 65-79, and ≥80 years) between BPV and hearing loss. The generalized additive Cox models were further used to visualize the combined effect of age and BPV.

Results: During the follow-up up to 7.0 years, 700 participants developed hearing loss. Among people aged under 65 years, we observed a 36% increased risk of hearing loss with per-SD increment in VIM of SBP (hazard ratio [HR] per SD 1.36, 95% confidence interval [CI] 1.13-1.63) and a slightly significant association between VIM of DBP (HR per SD 1.21, 95% CI 1.01-1.45) and hearing loss. We did not observe significant associations among groups aged over 65 years (p > .05). The generalized additive Cox models also showed younger participants had stronger associations between BPV and hearing loss.

Discussion and implications: Higher visit-to-visit variabilities of SBP were associated with an increased risk of hearing loss in middle-aged adults (50-65 years). Intervention in early BPV may help decrease hearing loss in adults aged over 50 years.

Keywords: Blood pressure; Generalized Cox additive model; Hearing health; Visit-to-visit variability.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Study design and recruitment of study population. SBP = systolic blood pressure; DBP = diastolic blood pressure.
Figure 2.
Figure 2.
Bivariate exposure–response surface plots of age and BPV (SD, CV, VIM) (n = 3,899).aNotes: BPV = blood pressure variability; CV = coefficient of variation; DBP = diastolic blood pressure; SD = standard deviation; VIM = variability independent of the mean. aExcluded participants whose BPV was in the largest 1%. Adjusted for individual average SBP or DBP, gender, race/ethnicity, marital status, educational level, antihypertensive medication use, diabetes, high cholesterol, cardiovascular diseases, smoking, drinking, physical activity, and body mass index.
Figure 2.
Figure 2.
Bivariate exposure–response surface plots of age and BPV (SD, CV, VIM) (n = 3,899).aNotes: BPV = blood pressure variability; CV = coefficient of variation; DBP = diastolic blood pressure; SD = standard deviation; VIM = variability independent of the mean. aExcluded participants whose BPV was in the largest 1%. Adjusted for individual average SBP or DBP, gender, race/ethnicity, marital status, educational level, antihypertensive medication use, diabetes, high cholesterol, cardiovascular diseases, smoking, drinking, physical activity, and body mass index.
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