Trends and mechanistic insights into hypertension-associated hearing loss: a 20-year perspective (2005-2025)

Hypertension and hearing loss (HL) are increasingly prevalent in rapidly aging societies and pose major public health challenges; existing evidence suggests a potential association between the two. Although the association between hypertension and HL has received extensive attention, there is still a lack of in-depth exploration and systematic summary regarding the potential molecular interaction mechanisms underlying their coexistence, as well as the overall research trends in this field.

Publications from 2005 to 2025 were retrieved from the Web of Science Core Collection, Scopus, and PubMed; 2,351 records were included and analyzed using Bibliometrix, CiteSpace, and VOSviewer. In parallel, GeneCards, GEO, and STRING were used to identify and integrate relevant molecular targets and pathways.

Overall publication output showed a sustained upward trend, with the United States and China contributing most prominently. Keyword and clustering analyses highlighted aging- and sex-related themes (such as "aged," "male") and suggested a shift from descriptive clinical observations toward etiological and therapeutic investigations. Author- and institution-level analyses indicated that Frank Robert Lin, Harvard University, and Johns Hopkins University were highly active and influential in this field. Gene intersection analysis identified 903 genes shared between hypertension and HL; IL1A, TGFB1, EGFR, MMP9, TP53, ICAM1, and BCL2 emerged as prominent network nodes. Enrichment analyses of GeneCards-derived genes and GEO-derived differentially expressed genes consistently implicated the AGE-RAGE, PI3K-Akt, and cGMP-PKG signaling pathways, fluid shear stress and atherosclerosis, as well as biological processes involving the response to oxidative stress and the regulation of blood circulation.

These findings support incorporating hearing risk stratification and early screening into hypertension management and provide a mechanistic framework for actionable multi-target strategies, potentially enabling earlier identification and intervention and reducing subsequent treatment burden.