Tinnitus and cardiovascular disease: the population-based Tromsø Study (2015-2016).

Introduction: People with tinnitus are likely to have other co-occurring disorders that should be considered when diagnosing and understanding tinnitus as a health problem. The association between tinnitus and cardiovascular health in the general population is, however, unclear. This study aimed to examine whether tinnitus is associated with the prevalence of hypertension, myocardial infarction or stroke, in the general adult population. Methods: We used data from the seventh survey of the Tromsø Study, a comprehensive population-based health study carried out in 2015-2016. All inhabitants aged ≥40 years in the municipality of Tromsø, Norway, (n=32 591) were invited, of which 21 083 individuals (65%), aged 40-99, participated. Poisson regression was used to analyse the relationships between tinnitus and cardiovascular disease, while adjusting for relevant covariates. We used three separate tinnitus variables as exposures in analyses: (1) 'tinnitus status', measured with the question 'During the last 12 months, have you experienced ringing in your ears lasting more than five min?'; (2) 'tinnitus symptom intensity', generated as a function of tinnitus frequentness and tinnitus bother; and (3) 'tinnitus bother', analysed only among participants with tinnitus. Hypertension (measured blood pressure and/or self-reported use of antihypertensives), and self-reported myocardial infarction and stroke were the outcomes of analyses. Results: Analyses of the complete sample (n=17 288, 51.2% women), in fully adjusted models, revealed non-significant and very weak associations between tinnitus status and all three cardiovascular outcomes (prevalence ratios (PRs): 1.04-1.11), while for tinnitus symptom intensity, we found significant positive associations between low-intensity tinnitus and hypertension (PR: 1.08, 95% CI: (1.01 to 1.16) and myocardial infarction (PR: 1.39, 95% CI: 1.07 to 1.81). Among participants with tinnitus (n=3570), there were no associations between tinnitus bother and cardiovascular outcomes. Conclusions: Results from the present study indicate that there is a weak association between tinnitus and cardiovascular disease and that tinnitus should be taken seriously even at low intensities.