Age-specific association between visit-to-visit blood pressure variability and hearing loss: A population-based cohort study

Innovation in Aging Pub Date : 2024-05-07 DOI:10.1093/geroni/igae047

Xinyue Guo, Renjian Sun, Xiaorui Cui, Yahang Liu, Yating Yang, Rui-jin Lin, Hui Yang, Jingyi Wu, Jiaqin Xu, Yuwei Peng, Xueying Zheng, Guoyou Qin, Jiaohua Chen

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Abstract

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. This nationally representative cohort study included 3939 adults over 50 years from the Health and Retirement Study in the US. Variabilities of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by standard deviation (SD), coefficient of variation (CV) and variability independent of the mean (VIM), using SBP and DBP from three 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. 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 (HR per SD 1.36, 95% 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>0.05). The generalized additive Cox models also showed younger participants had stronger associations between BPV and hearing loss. 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.

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逐次就诊血压变化与听力损失之间的特定年龄关联：基于人群的队列研究

听力损失是一种常见病，且治疗不足，而血压变化（BPV）对听力损失发展的影响仍不清楚。我们的目的是研究逐次血压变异与听力损失之间的特定年龄关联。这项具有全国代表性的队列研究纳入了美国健康与退休研究（Health and Retirement Study）中 3939 名 50 岁以上的成年人。使用三次就诊的收缩压（SBP）和舒张压（DBP），通过标准差（SD）、变异系数（CV）和独立于平均值的变异性（VIM）来评估收缩压（SBP）和舒张压（DBP）的变异性。听力损失通过自评问题进行评估。采用 Cox 比例风险模型评估 BPV 与听力损失之间的特定年龄关联（50-64 岁、65-79 岁和≥80 岁）。此外，还使用广义加法 Cox 模型来显示年龄和 BPV 的综合影响。在长达 7.0 年的随访期间，有 700 名参与者出现了听力损失。在 65 岁以下的人群中，我们观察到 SBP 的 VIM 每增加一个 SD 值，听力损失的风险就会增加 36%（HR 每增加一个 SD 值为 1.36，95% CI 为 1.13-1.63），DBP 的 VIM（HR 每增加一个 SD 值为 1.21，95% CI 为 1.01-1.45）与听力损失之间有轻微的相关性。在 65 岁以上的人群中，我们没有观察到明显的相关性（P>0.05）。广义加性 Cox 模型还显示，年轻参与者的 BPV 与听力损失之间的关联性更强。在中年人（50-65 岁）中，SBP 的逐次变异性越高，听力损失的风险越大。对早期 BPV 进行干预可能有助于减少 50 岁以上成年人的听力损失。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Innovation in Aging

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