Hearing loss is associated with increased risk of incident stroke but not coronary heart disease among middle-aged and older Chinese adults: the Dongfeng-Tongji cohort study

Hearing loss has been associated with increased risk of cardiovascular disease (CVD) prevalence in cross-sectional studies. However, little is known about the prospective association between hearing loss and CVD incidence. We aimed to examine the associations of hearing loss with risk of incident CVD, coronary heart disease (CHD), and stroke in a Chinese population. We included 13,880 individuals aged 63.3 years from the Dongfeng-Tongji cohort study (2013–2018). Hearing loss was categorized into normal, mild, moderate, severe, or greater by the pure-tone average of thresholds at speech and high frequency in both ears. Cox proportional hazard models and linear regression models were used for multivariate longitudinal analyses. After multivariate adjustments, we observed suggestive dose–response associations of increased high-frequency hearing loss with elevated risk of CVD and stroke incidence. Compared with normal hearing loss at high frequency, those with moderate and severe or greater hearing loss had a 4% (95% CI: 0.92, 1.18) or 13% (95% CI: 0.98, 1.30) higher risk of CVD and 52% (95% CI: 1.06, 2.17) or 51% (95% CI: 1.03, 2.20) higher risk of stroke, while the associations were almost consistent across most subgroups. No significant associations were observed for CHD and high-frequency hearing loss, as well as CVD and speech-frequency hearing loss. In addition, higher high-frequency hearing loss was related to unfavorably altered lipid profiles and fasting glucose. Our data suggested that increased hearing loss might increase the risk of incident CVD and stroke among middle-aged and older Chinese, which was partially explained by altered CVD-related biomarkers.