Hearing Loss and Risk of Stroke and Myocardial Infarction: A Systematic Review and Meta-Analysis

Objective: This systematic review and meta-analysis aims to investigate the association between hearing loss (HL) and incident cardiovascular disease (CVD), a composite of stroke and myocardial infarction (MI), and to explore the specificity of the underlying pathophysiology and the consistency of this association across key demographics and HL types. Methods: Adhering to PRISMA and MOOSE guidelines, we searched PubMed and Web of Science for studies published in English over the past 16 years. The analysis encompassed the spectrum of HL types. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for CVD (a composite of stroke and MI) and for each outcome separately. Extensive subgroup and sensitivity analyses were performed to assess robustness amid heterogeneity. Results: The analysis included 15 studies (12 cohort, 3 cross-sectional/case-control). HL was significantly associated with a high incidence of CVD (pooled OR = 1.31, 95% CI 1.05-1.65). A significant association was found for stroke (OR = 1.41, 95% CI 1.07-1.85) but not for MI (OR = 1.15, 95% CI 0.88-1.50). A consistent pattern of elevated risk was observed across all subgroups, and the primary findings remained robust in sensitivity analyses. Conclusion: Our meta-analysis indicates that HL, across its various types, is significantly associated with incident stroke, but not MI. This differential risk profile is compatible with a pathophysiology that may involve the cerebrovascular system more prominently than systemic coronary arteries. The findings highlight the potential of HL as a cost-effective indicator meriting further investigation for targeted cerebrovascular risk assessment in prevention strategies.