The association between tinnitus and risk of cardiovascular events and all-cause mortality: insight from the UK Biobank

Abstract

Background

The potential influence of tinnitus on cardiovascular disease (CVD) and all-cause mortality has yet to be explored. We aim to examine the correlations between tinnitus and the risk of cardiovascular events and all-cause mortality.

Methods

We conducted a prospective cohort study utilising data from the UK Biobank. The presence of tinnitus was evaluated through a questionnaire. The primary outcome was defined as a composition of cardiovascular events, including myocardial infarction (MI), stroke, and mortality from CVD, as well as all-cause mortality. Cox proportional hazard models were employed to examine the associations between tinnitus and both the primary outcome and its individual components. Sensitivity analyses were conducted to evaluate the robustness of the primary analysis.

Results

A total of 140,146 participants were included in the study. The presence of tinnitus was found to be associated with a higher incident rate of the primary outcome (HR = 1.057, 95%CI: 1.017–1.099, p = 0.005), MI (HR = 1.139, 95%CI: 1.061–1.222, p < 0.001) and all-cause mortality (HR = 1.053, 95%CI: 1.003–1.105, p = 0.038) after adjusting for confounders. However, there was no significant association between tinnitus and stroke or mortality from CVD. Subgroup analysis revealed that the association between tinnitus and the primary outcome was significant in females, participants with abnormal BMI, and those without hearing difficulty, depression or anxiety. Sensitivity analyses yielded consistent results.

Conclusion

The findings from this study contribute to the existing body of evidence suggesting an association between tinnitus and an increased risk of cardiovascular events and all-cause mortality.

Keywords:

• Myocardial infarction
• stroke
• mortality from cardiovascular disease
• all-cause mortality
• tinnitus

Author contributions

Hai-Feng Zhang conceived the original idea. Yi-Peng Zhang, Qing-Yuan Gao and Jing-Wei Gao conducted the data preparation and analysis. Yi-Peng Zhang wrote the first draft of the article. Yi-Peng Zhang, Qing-Yuan Gao and Jing-Wei Gao are co-first authors. All authors directly participated in the interpretation of the results, provided critical comments to the article, and revised the text. All authors of this research article have read and approved the final version submitted. Yi-Peng Zhang, Hai-Feng Zhang and Jing-Feng Wang had full access to all of the data in the study and take responsibility for its integrity and the data analysis.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (grant no. 82070237, 82270254, 81900379 and 82200306), Guangdong Basic and Applied Basic Research Foundation (grant no. 2020A1515011237 and 2021A1515111092), Guangzhou Basic and Applied Basic Research Foundation (grant no. 202201010940), Guangzhou Regenerative Medicine and Health Guangdong Laboratory (grant no. 2019GZR110406004), and Guangzhou Key Laboratory of Molecular Mechanism and Translation in Major Cardiovascular Disease (grant no. 202102010007).