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Association Between Hearing Loss and Cardiovascular Disease: A Meta-analysis
Claire Jing-Wen Tan1, Jia Wen Tricia Koh1, Benjamin Kye Jyn Tan1
1Department of Otolaryngology-Head and Neck Surgery, Yong Loo Lin School of Medicine, National University Hospital, Singapore City, Singapore.
Insights
Hearing loss (HL) is strongly associated with increased risk of cardiovascular diseases (CVDs), including stroke and coronary artery disease (CAD). This highlights the importance of considering hearing health in overall cardiovascular risk assessment.
Area of Science:
- Cardiology
- Otolaryngology
- Epidemiology
Background:
- Hearing loss (HL) is increasingly recognized as a potential indicator of underlying vascular dysfunction.
- Epidemiological evidence linking HL to cardiovascular diseases (CVDs) remains inconclusive, necessitating further investigation.
Approach:
- A systematic review and meta-analysis of observational studies was conducted using data from PubMed, Embase, and SCOPUS up to April 2022.
- Included studies compared the incidence of stroke, coronary artery disease (CAD), and any CVD in individuals with and without HL.
- Random-effects meta-analyses were employed to pool odds ratios (ORs) for the association between HL and CVD outcomes.
Key Points:
- The meta-analysis synthesized data from 4 cohort and 6 cross-sectional studies, encompassing over 1.6 million participants.
- A significant association was found between HL and increased risk of stroke (pooled OR=1.26), CAD (pooled OR=1.36), and any CVD (pooled OR=1.38).
- Both low- and high-frequency hearing loss demonstrated a notable association with stroke risk.
Conclusions:
- HL and CVDs are closely interrelated, suggesting shared underlying vascular mechanisms.
- Healthcare providers should consider hearing status as part of a comprehensive cardiovascular risk assessment.
- This association underscores the importance of viewing HL within the broader context of general health and aging.
Objective:
Hearing loss (HL) has been postulated to be linked to cardiovascular diseases (CVDs) via vascular mechanisms, but epidemiological associations remain unclear. The study aims to clarify the association between HL and stroke, coronary artery disease (CAD), and any CVD.
Data Sources:
PubMed, Embase, and SCOPUS from inception until April 27, 2022.
Review Methods:
Three blinded reviewers selected observational studies reporting stroke, CAD, and any CVD in patients with HL, compared to individuals without HL. We extracted data, evaluated study bias using the Newcastle-Ottawa scale, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and a PROSPERO-registered protocol (CRD42022348648). We used random-effects inverse variance meta-analyses to pool the odds ratios (ORs) for the association of HL with stroke, CAD, and any CVD.
Results:
We included 4 cohort studies (N = 940,771) and 6 cross-sectional studies (N = 680,349). Stroke, CAD, and any CVD were all strongly associated with HL. The overall pooled OR of the association between HL and stroke was 1.26 (95% confidence interval [CI] = 1.16-1.37, I2 = 78%), and was 1.33 (95% CI = 1.12-1.58) and 1.29 (95% CI = 1.14-1.45) for low- and high-frequency HL, respectively. Minimal publication bias was observed, with minimal change to pooled effect size following trim and fill. Similarly, the pooled OR of the association between HL and CAD was 1.36 (95% CI = 1.13-1.64, I2 = 96%), while that between HL and any CVD was 1.38 (95% CI = 1.07-1.77, I2 = 99%).
Conclusion:
Our findings suggest that HL and CVD are closely related. Physicians treating patients with HL should be cognizant of this association and view HL in the broader context of general health and aging.
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