Abstract
We aimed to investigate the association between hearing loss and all-cause and cardiovascular disease (CVD) mortality, and whether the relationship could be modified by chronic conditions in middle-aged and older Chinese adults. We selected 18,625 participants who underwent audiometry in 2013 from the Dongfeng-Tongji Cohort conducted in China, and followed them until December 2018. Hearing loss was grouped as normal, mild, and moderate or severe by pure-tone hearing threshold at speech (0.5, 1, and 2 kHz) and high frequency (4 and 8 kHz). We applied Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and CVD mortality. Among the 18,625 participants, the mean age was 64.6 (range: 36.7–93.0) years, and 56.2% were women. A total of 1185 died, with 420 CVD deaths during a mean follow-up period of 5.5 years. The adjusted HR for all-cause and CVD mortality increased gradually with the increasing hearing threshold (All p for trend < 0.05). Compared to participants with normal hearing at speech frequency, the adjusted HRs (95% CIs) of moderate or severe hearing loss were 1.42 (1.21–1.67), 1.44 (1.10–1.89), and 1.92 (1.21–3.04) for all-cause, CVD, and stroke mortality, respectively. While moderate or severe hearing loss at high frequency was only related to an increased risk of all-cause mortality (HR, 1.60; 95% CI, 1.18–2.17). The associations were generally consistent across subgroups (All p for interaction > 0.05). Additionally, individuals with a combination of moderate or severe hearing loss and occupational noise exposure, diabetes, or hypertension had higher risk of all-cause or CVD mortality, ranging from 1.45 to 2.78. In conclusion, hearing loss was independently associated with an increased risk of all-cause and CVD mortality, in a dose–response manner. Meanwhile, hearing loss and diabetes or hypertension could jointly increase the risk of all-cause and CVD mortality.
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Abbreviations
- BMI:
-
Body mass index
- CHD:
-
Coronary heart disease
- CI:
-
Confidence interval
- CVD:
-
Cardiovascular disease
- DBP:
-
Diastolic blood pressure
- FPG:
-
Fasting plasma glucose
- HR:
-
Hazard ratio
- ICD-10:
-
International Classification of Diseases, 10th Revision
- SBP:
-
Systolic blood pressure
- T2DM:
-
Type 2 diabetes mellitus
- TC:
-
Total cholesterol
- TG:
-
Triglycerides
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Acknowledgements
The authors would like to give great gratitude to the participants, all research staff of the DFTJ Cohort Study.
Funding
This work was supported by the Key Research and Development Program of Hubei Province (2022BCA046). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
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All authors contributed to the study conception and design. Concept and design: Xiaomin Zhang and Weijia Kong. Acquisition, analysis, or interpretation of the data: all authors. Drafting of the manuscript: Haiqing Zhang and Qin Fang. Critical revision of the manuscript for important intellectual contents: all authors. Statistical analysis: Haiqing Zhang, Qin Fang, and Meng Li. Obtained funding: Xiaomin Zhang. Administrative, technical, or material support: Liangle Yang, Xuefeng Lai, and Zhichao Wang. Supervision: Meian He.
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Zhang, H., Fang, Q., Li, M. et al. Hearing loss increases all-cause and cardiovascular mortality in middle-aged and older Chinese adults: the Dongfeng-Tongji Cohort Study. Environ Sci Pollut Res 30, 78394–78407 (2023). https://doi.org/10.1007/s11356-023-27878-2
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DOI: https://doi.org/10.1007/s11356-023-27878-2