title: Positive Association between Tinnitus and Arterial Hypertension.
abstract: BACKGROUND
  Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multifactorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme.
  
  
  OBJECTIVE
  To analyze the presence of arterial hypertension in tinnitus and non-tinnitus patients, to analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients, and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed.
  
  
  METHODS
  This includes cross-sectional transversal study, comparing two groups of subjects (144 in the study group with tinnitus and 140 in the control group without tinnitus). Clinical, demographical, audiometrical, and psychoacoustics characteristics of the subjects were compared.
  
  
  RESULTS
  Hypertension prevalence in tinnitus subjects was 44.4% against 31.4% in subjects without tinnitus (p= 0.024). Positive associations with tinnitus were found with hypertension treatment with angiotensin-converting enzyme (ACE) inhibitors (p= 0.006), tiazidic diuretics (p< 0.0001), potassium-sparing diuretics (p= 0.016), and calcium channels blockers (p= 0.004).
  
  
  CONCLUSIONS
  There is an association between tinnitus and arterial hypertension. This association is particularly strong in older patients. Hypertension treatment with diuretics, ACE inhibitors, and calcium channels blockers were more prevalent in tinnitus patients, suggesting that an eventual ototoxicity of these drugs may be involved in tinnitus pathophysiology, a hypothesis that should be evaluated in further studies.
authors.affiliation: Otolaryngology, Universidade Federal de São Paulo, São Paulo, Brazil; Otolaryngology, Faculdade de Medicina de Valença, Valença, Brazil.
authors.forename: Ricardo Rodrigues
authors.initials: RR
authors.lastname: Figueiredo
authors.affiliation: Otolaryngology, Universidade Federal de São Paulo , São Paulo , Brazil.
authors.forename: Andréia Aparecida
authors.initials: AA
authors.lastname: Azevedo
authors.affiliation: Otolaryngology, Universidade Federal de São Paulo , São Paulo , Brazil.
authors.forename: Norma De Oliveira
authors.initials: NO
authors.lastname: Penido
keywords: arterial hypertension; cardiovascular diseases; hearing disorders; hearing loss; tinnitus