From Dr. Darrow: The Association Between Hypertension and Hearing Loss - Understanding the Connection

Hearing loss affects millions of adults worldwide, often developing gradually over time. While age and noise exposure are well-known contributors, emerging evidence suggests that cardiovascular health—particularly hypertension (high blood pressure)—plays a significant role in hearing function. The connection between these two conditions lies in the body’s intricate vascular system, where compromised blood flow can have a profound impact on the delicate structures of the inner ear.

How Hypertension Affects Hearing

The inner ear, specifically the cochlea, relies on a rich network of tiny blood vessels to supply oxygen and essential nutrients. When blood pressure remains consistently elevated, it can damage the walls of these small vessels, leading to microvascular changes that restrict blood flow. Over time, this diminished circulation can impair the sensory cells (hair cells) responsible for converting sound waves into electrical signals the brain interprets as sound.

Once these hair cells are damaged, they cannot regenerate—resulting in permanent sensorineural hearing loss. This effect is often most noticeable at high frequencies, which are crucial for understanding speech, especially in noisy environments.

The Evidence Behind the Link

Several studies have highlighted the association between hypertension and hearing decline. Research indicates that individuals with high blood pressure are more likely to experience hearing loss than those with normal blood pressure levels. Additionally, the severity and duration of hypertension appear to correlate with the degree of hearing impairment.

One theory is that hypertension accelerates age-related hearing loss (presbycusis) by reducing cochlear blood flow and oxygenation. Another hypothesis suggests that hypertension increases the risk of inner ear hemorrhage or metabolic stress, both of which can damage auditory structures.

Interestingly, some studies have also found that effective management of blood pressure—through lifestyle changes and medication—may help slow the progression of hearing loss, emphasizing the importance of overall cardiovascular health.

Recognizing the Warning Signs

Hearing loss linked to hypertension often develops gradually, making it easy to overlook. Common signs include:

• Frequently asking others to repeat themselves
• Difficulty understanding speech in background noise
• Turning up the volume on the TV or phone
• Ringing in the ears (tinnitus)
• Feeling that others “mumble” or speak unclearly

If you experience these symptoms and have a history of high blood pressure, it’s important to discuss both conditions with your healthcare provider.

What You Can Do

The good news is that taking care of your cardiovascular system can also support your hearing health. Consider these steps:

• Monitor and manage your blood pressure regularly.
• Adopt a heart-healthy diet rich in fruits, vegetables, and whole grains, and low in sodium and processed foods.
• Exercise regularly to improve circulation and reduce blood pressure.
• Avoid smoking and limit alcohol intake, as both can exacerbate vascular damage.
• Schedule routine hearing evaluations, especially if you have hypertension or other cardiovascular risk factors.

How Audiologists Can Help

As an audiologist, my role extends beyond assessing hearing thresholds. I focus on the whole patient, understanding how medical conditions like hypertension, diabetes, and high cholesterol can impact auditory health. Through comprehensive hearing evaluations and collaborative care with primary physicians and cardiologists, we can identify early changes and implement strategies to preserve hearing.

By addressing hearing concerns proactively, we can improve not only communication but also quality of life, mental well-being, and social engagement—all of which are affected by untreated hearing loss.

Resources for Further Information

• American Speech-Language-Hearing Association (ASHA): www.asha.org
• American Heart Association (AHA): www.heart.org
• National Institute on Deafness and Other Communication Disorders (NIDCD): www.nidcd.nih.gov

In summary, hypertension doesn’t just affect the heart—it impacts the ears, too. Recognizing and managing this connection empowers individuals to take control of both cardiovascular and hearing health, leading to better outcomes and a more vibrant, connected life.

Discussion Guide: Hypertension and Hearing Health in Women Over Sixty

As we age, it becomes increasingly important to take a proactive approach to our health. Many women know that managing blood pressure is vital for heart health — but few realize how closely it’s linked to hearing wellness. This discussion guide explores how hypertension can impact hearing and offers thoughtful questions to spark conversation, reflection, and empowerment.

1. Have you noticed any recent changes in your hearing—such as needing to turn up the TV, asking people to repeat themselves, or hearing ringing in your ears—and have you discussed them with your doctor?

Talking Points:

• Hearing loss can develop slowly and subtly.
• Tinnitus (ringing or buzzing in the ears) can sometimes be an early sign of vascular or inner ear changes.
• Discussing even mild changes with your provider can help identify issues early and prevent further decline.

2. Do you regularly monitor your blood pressure, and are you aware of how blood pressure control might influence your long-term hearing health?

Talking Points:

• Consistently high blood pressure can reduce circulation to the inner ear, damaging tiny sensory cells critical for hearing.
• Healthy blood pressure management—through medication, diet, and exercise all supports both heart and hearing.
• Many pharmacies, clinics, and community centers offer free or low-cost blood pressure checks.

3. How do you currently support your cardiovascular health through lifestyle choices like diet, exercise, and stress management—and could these same habits benefit your hearing?

Talking Points:

• A diet rich in fruits, vegetables, whole grains, and lean proteins supports healthy circulation.
• Regular physical activity improves oxygen delivery throughout the body, including to the auditory system.
• Reducing sodium, staying hydrated, and managing stress also help keep both your heart and ears healthy.

4. Many women experience both hearing loss and hypertension as they age. How might untreated hearing loss affect your independence, relationships, or emotional well-being?

Talking Points:

• Untreated hearing loss can lead to social withdrawal, frustration, and even depression.
• Struggling to hear can increase mental fatigue and reduce confidence in social situations.
• Treating hearing loss early—through hearing aids, assistive devices, or communication strategies—can greatly improve quality of life and maintain independence.

5. When was your last hearing test, and would you consider making routine hearing evaluations part of your annual health checkup, especially since hypertension can be a silent contributor to hearing decline?

Talking Points:

• Annual hearing screenings, much like blood pressure checks, are an important part of healthy aging.
• Many hearing clinics offer complimentary screenings or special events for seniors.
• Early detection allows for more treatment options and helps preserve communication and brain health.

Hearing health is heart health. Managing blood pressure, staying active, and prioritizing routine hearing evaluations are powerful ways to protect both. By understanding the link between hypertension and hearing loss, women can take meaningful steps toward maintaining vitality, independence, and connection as they age.

If you or someone you know would like more information on hearing health, I invite you to explore one of our Preventing Decline Provider Clinics near you.