title: Subclinical atherosclerosis and increased risk of hearing impairment.
abstract: OBJECTIVE
  The study's purpose was to test if subclinical atherosclerosis was associated with the risk of developing HI in a large cohort of middle-aged participants.
  
  
  METHODS
  Study subjects were members of the Beaver Dam Offspring Study (BOSS), a longitudinal study of adult children of participants in the population-based Epidemiology of Hearing Loss Study (1993-present). BOSS examinations took place in 2005-2008 (baseline) and 2010-2013 (5-year follow-up). The 5-year incidence of hearing impairment was defined as a pure-tone average (PTA) of thresholds at 0.5, 1, 2 and 4 kHz > 25 dB Hearing Level (dB HL) in either ear at follow-up among participants at risk (baseline PTA in both ears < = 25 dB HL; n = 2436, mean age = 47.7 years). Atherosclerosis was measured as the mean carotid intima-media thickness and the presence of carotid artery plaque.
  
  
  RESULTS
  Among the 1984 participants at-risk with a follow-up audiometric examination, the 5-year incidence of hearing impairment was 8.3% (95% Confidence Interval (C.I.) 7.1, 9.5). With multivariable adjustment, carotid intima-media thickness was positively associated with hearing impairment incidence (Relative Risk (RR) = 1.14 per 0.1 mm, 95% C.I. 1.04, 1.24). The number of sites (0-6) with plaque was also positively associated with the incidence of impairment (RR = 1.16 per site, 95% C.I. 1.01, 1.32).
  
  
  CONCLUSIONS
  Atherosclerosis was associated with the 5-year incidence of hearing impairment in this predominantly middle-aged cohort. Interventions targeting atherosclerosis prevention may help to prevent or delay the onset of hearing impairment.
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: fischer@episense.wisc.edu.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Fischer
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: schubert@episense.wisc.edu.
authors.forename: Carla R
authors.initials: CR
authors.lastname: Schubert
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: nondahl@episense.wisc.edu.
authors.forename: David M
authors.initials: DM
authors.lastname: Nondahl
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: dalton@episense.wisc.edu.
authors.forename: Dayna S
authors.initials: DS
authors.lastname: Dalton
authors.affiliation: Institute of Statistics, National Chiao Tung University, 1001 Ta Hsueh Road, Hsinchu, 300, Taiwan. Electronic address: ghuang@stat.nctu.edu.tw.
authors.forename: Guan-Hua
authors.initials: GH
authors.lastname: Huang
authors.affiliation: Perelman School of Medicine, University of Pennsylvania, 1016 Abramson Building, 3615 Civic Center Boulevard, Philadelphia, PA, 19104, USA. Electronic address: bkeating@mail.med.upenn.edu.
authors.forename: Brendan J
authors.initials: BJ
authors.lastname: Keating
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: kleinb@epi.ophth.wisc.edu.
authors.forename: Barbara E K
authors.initials: BE
authors.lastname: Klein
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: kleinr@epi.ophth.wisc.edu.
authors.forename: Ronald
authors.initials: R
authors.lastname: Klein
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: Tedt@tds.net.
authors.forename: Ted S
authors.initials: TS
authors.lastname: Tweed
authors.affiliation: Department of Ophthalmology and Visual Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA; Department of Population Health Sciences, University of Wisconsin, 610 Walnut Street, Madison, WI, 53726, USA. Electronic address: cruickshanks@episense.wisc.edu.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Cruickshanks
mesh_terms: D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000175:diagnosis / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D015994:Incidence; D016018:Least-Squares Analysis; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014922:Wisconsin / Q000453:epidemiology; D055815:Young Adult
keywords: Carotid artery plaque; Carotid intima-media thickness; Hearing impairment; Longitudinal cohort; Subclinical atherosclerosis