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Updated: Oct 27, 2025
A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
Abnormal hearing patterns are not associated with endothelium-dependent vasodilation and carotid intima-media
Sudhi Tyagi1, David R Friedland2, Lisa Rein3
1Department of Medicine, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
Insights
This study found no significant link between specific hearing loss patterns and cardiovascular markers like carotid intima-media thickness or endothelial dysfunction in adults without prior heart disease. Further research may explore age and sex influences on these associations.
Area of Science:
- Cardiology
- Otolaryngology
- Vascular Biology
Background:
- Hearing loss is linked to cardiovascular risk factors and disease.
- The association between specific hearing loss patterns, particularly the strial pattern, with systemic endothelial dysfunction and carotid intima-media thickness (IMT) is not well understood.
Purpose of the Study:
- To investigate the relationship between distinct audiogram patterns and measures of endothelial function and carotid artery structure.
- To determine if a strial hearing loss pattern is associated with subclinical cardiovascular disease.
Main Methods:
- 1672 participants from the Framingham Offspring Study without prevalent cardiovascular disease (CVD) were analyzed.
- Audiograms were classified into normal or four abnormal patterns (cochlear-conductive, low-sloping, sensorineural, strial).
- Endothelial function (brachial artery flow-mediated dilation - FMD) and carotid intima-media thickness (IMT) were assessed via ultrasound.
Main Results:
- Strial hearing loss was more prevalent in individuals with the highest common carotid intima-media thickness (ccIMT) and internal carotid intima-media thickness (icIMT).
- No significant differences were observed in brachial artery flow-mediated dilation (FMD) across hearing loss patterns.
- Age- and sex-adjusted regression models did not reveal significant associations between hearing patterns and vascular measures.
Conclusions:
- Abnormal hearing patterns were not significantly associated with impaired brachial FMD or increased carotid IMT after adjusting for age and sex.
- Observed associations may be influenced by age- and sex-related distributional differences in hearing loss patterns.
Introduction:
Prior data suggest associations between hearing loss, cardiovascular (CV) risk factors, and CV disease. Whether specific hearing loss patterns, including a strial pattern associated with inner ear vascular disease, are associated with systemic endothelial dysfunction and carotid intima-media thickness (IMT) remains unclear.
Methods:
We evaluated participants without prevalent CVD in the Framingham Offspring Study who underwent formal audiogram testing and brachial and carotid artery ultrasounds. Audiograms were categorized as normal or as belonging to one of four abnormal patterns: cochlear-conductive, low-sloping, sensorineural, or strial. Endothelial function as measured by brachial artery flow-mediated dilation (FMDmm and FMD%). Internal and common intima-media thicknesses (icIMT and ccIMT, respectively) were compared between audiogram patterns.
Results:
We studied 1672 participants (mean age 59 years, 57.6% women). The prevalence of each hearing pattern was as follows: 43.7% normal; 20.3% cochlear-conductive; 20.3% sensorineural; 7.7% low-sloping; and 8.0% strial. Strial pattern hearing loss was nearly twice as prevalent (p = 0.001) in those in the highest quartile of ccIMT and nearly 50% higher in those in the highest icIMT quartile (p = 0.04). There were no statistically significant differences between the prevalence of the strial pattern comparing the lowest quartiles of FMDmm and FMD% with the upper three quartiles. Age- and sex-adjusted linear regression models did not show significant associations between the vascular measures and hearing patterns.
Conclusion:
Abnormal hearing patterns were not significantly associated with impaired brachial FMD and increased carotid IMT after adjusting for age and sex effects, which may reflect age and sex-related distributional differences based on hearing loss pattern.
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