Tinnitus is Not Associated with Cardiovascular Risk Factors or Mortality in the Gutenberg Health Study.

Omar Hahad,Berit Hackenberg, Julia Döge, Katharina Bahr-Hamm, Jasmin Ghaemi Kerahrodi, Oliver Tüscher,Matthias Michal, Konstantin Kontohow-Beckers,Alexander K Schuster,Irene Schmidtmann,Karl J Lackner, Jörn M Schattenberg,Stavros Konstantinides,Philipp S Wild,Thomas Münzel

Clinical research in cardiology official journal of the German Cardiac Society（2025）

German Center for Cardiovascular Research (DZHK)

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Abstract

BACKGROUND AND AIMS:Tinnitus, characterized by the conscious perception of sound without external acoustic stimulation, presents a multifaceted challenge. Recent research suggests a potential association between tinnitus and cardiovascular health. To elucidate these associations further, we examined the prevalence of tinnitus alongside its distress levels and their associations with cardiovascular risk factors, diseases, and risk of death within a general population cohort. METHODS AND RESULTS:This study analyzed data from the prospective Gutenberg Health Study (GHS), a population-based cohort of 15,010 individuals aged 35-74, who underwent baseline assessments from 2007 to 2012. We focused on the 10-year follow-up (2017-2020) of the GHS, including otologic testing with 8539 subjects, of whom 2387 (28%) reported tinnitus, allowing for a comprehensive cross-sectional and prospective analysis. Participants completed a questionnaire on hearing-related symptoms, including tinnitus presence ("Do you suffer from ringing in the ears (tinnitus)?" yes/no) and distress ("How much do you feel bothered by it?"), rated on a six-point scale from 0 ("not bothersome") to 5 ("very bothersome"). Outcomes were assessed based on observed prevalent cardiovascular conditions (i.e., cardiovascular risk factors and diseases) and deaths. Additionally, calculated cardiovascular risk was assessed using the SCORE2 algorithm. Significant differences in baseline characteristics emerged between participants with and without tinnitus, with the former exhibiting advanced age, male predominance, and a higher prevalence of cardiovascular risk factors and diseases. Tinnitus displayed associations with various prevalent cardiovascular diseases including atrial fibrillation (odds ratio 1.48, 95% confidence interval 1.11-1.96), peripheral artery disease (1.43, 1.05-1.95), coronary artery disease (1.49, 1.09-2.04), and any cardiovascular disease (1.31, 1.11-1.56), persisting even after adjustments for demographic, socioeconomic, and cardiovascular risk factors. While crude associations with several prevalent cardiovascular risk factors were observed, these associations diminished upon comprehensive adjustment. Tinnitus presence was associated with elevated 10-year cardiovascular disease risk (incidence rate ratio 1.11, 1.09-1.13), as indicated by higher SCORE 2 values, yet did not predict all-cause mortality risk. CONCLUSIONS:In the present study, tinnitus was associated with prevalent cardiovascular disease. However, no association with cardiovascular risk factors and mortality was found.

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【要点】：该研究通过 Gutenberg Health Study 数据表明，耳鸣与心血管疾病存在相关性，但与心血管风险因素和死亡率无显著关联。

【方法】：研究采用前瞻性队列研究方法，对15,010名年龄在35-74岁之间的参与者进行了10年随访，重点关注了其中8539名参与者的耳科检查结果。

【实验】：在 Gutenberg Health Study 数据集中，通过对耳鸣的存在与否及其困扰程度进行问卷调查，并结合心血管条件及死亡情况进行分析，发现耳鸣与多种心血管疾病存在显著相关性，但经调整后与心血管风险因素和死亡率无显著关联。