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Audiometric pattern as a predictor of cardiovascular status: development of a model for assessment of risk. Laryngoscope 2009 Mar;119(3):473-86

Date

02/25/2009

Pubmed ID

19235737

DOI

10.1002/lary.20130

Scopus ID

2-s2.0-64849094604 (requires institutional sign-in at Scopus site)   88 Citations

Abstract

OBJECTIVES/HYPOTHESIS: This study hypothesizes that low-frequency hearing loss is associated with underlying cardiovascular disease. The objective of this study was to use a mathematical model of hearing thresholds to predict cardiovascular status.

STUDY DESIGN: Logistic regression analyses of audiometric and cardiovascular data obtained through retrospective chart review. Application of a derived mathematical formula to a distinct prospectively enrolled cohort.

METHODS: Cardiovascular status was determined for a cohort of 1,168 patients seen in the audiology division. Associations between audiogram pattern and cardiovascular variables were tested with the Mantel-Haenszel statistic controlling for age and gender. Logistic regression models were developed incorporating cardiovascular risk factors and audiogram pattern. The models were applied to a separate cohort of 90 subjects recruited from cardiology and geriatric medicine clinics in whom audiograms were performed.

RESULTS: A significant association was found between low-frequency hearing loss and cardiovascular disease and risk factors. When controlling for age, hypertension, diabetes, smoking, and hyperlipidemia, low-frequency presbycusis was significantly associated with intracranial vascular pathology such as stroke and transient ischemic attacks. Significant associations were also seen with peripheral vascular disease, coronary artery disease, and a history of myocardial infarction. A mathematical formula using audiometric pattern and medical history to predict the probability of cardiovascular diseases and events was developed and tested.

CONCLUSIONS: Audiogram pattern correlates strongly with cerebrovascular and peripheral arterial disease and may represent a screening test for those at risk. Patients with low-frequency hearing loss should be regarded as at risk for cardiovascular events, and appropriate referrals should be considered.

Author List

Friedland DR, Cederberg C, Tarima S

Authors

David R. Friedland MD Associate Director, Director, Chief, Professor in the Otolaryngology department at Medical College of Wisconsin
Sergey S. Tarima PhD Associate Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Audiometry
Cardiovascular Diseases
Female
Hearing Loss
Humans
Male
Middle Aged
Models, Theoretical
Predictive Value of Tests
Prevalence
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Wisconsin