Hearing Loss: A Red Flag for Heart Health?

Hearing impairment, especially when not addressed by hearing aids, increases the risk of heart failure due to social isolation, psychological distress, and neuroticism.

Highlights:

Poor hearing and hearing aid use are linked to a higher risk of heart failure
Hearing loss increases heart failure risk via social isolation and psychological distress
Hearing issues may reflect broader vascular health concerns, serving as an early indicator of cardiovascular disease

A large, long-term study published in the journal Heart has revealed a link between hearing loss and a heightened risk of developing heart failure. Psychological distress caused by hearing impairment plays a significant role in this association, according to the findings ().

Hearing loss is becoming more common, especially among aging individuals, while heart failure also continues to increase in prevalence, currently affecting around 64 million people worldwide. Researchers note the growing concern over this dual burden of conditions.

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Objective Measurement of Hearing Ability

Although hearing impairment is known to be linked with cardiovascular disease—largely due to social isolation—no study has thoroughly examined the relationship between objectively measured hearing ability and heart failure risk. To fill this knowledge gap, the study analyzed data from 164,431 participants in the UK Biobank. Of these, 4,369 wore hearing aids, and none had heart failure at the start of the study. The average age of participants was 56, with about 55% being women.

Hearing ability was objectively measured using two tests: The Digit Triplets Test (DTT) and Speech Reception Threshold (SRT). Participants without hearing aids (160,062 individuals) were classified into three groups based on their DTT performance: normal, insufficient, and poor hearing.

Types of Hearing Loss

There are three main types of hearing loss—conductive, sensorineural, and mixed.

Conductive hearing loss occurs when sound can’t travel efficiently through the outer or middle ear, often due to blockages or infections.
Sensorineural hearing loss results from damage to the inner ear or auditory nerve and is usually permanent.
Mixed hearing loss is a combination of both, affecting multiple parts of the hearing system.

Each type requires different approaches for diagnosis and treatment.

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Social Isolation and Psychological Distress

Alongside hearing tests, comprehensive background information was gathered on health, lifestyle, and psychosocial factors. Social isolation was assessed using a composite definition, and individuals with lower scores for social engagement were categorized as socially isolated. Psychological distress was evaluated with the Patient Health Questionnaire (PHQ-4), while neuroticism was assessed through a short form of the Eysenck Personality Questionnaire.

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Impact of Hearing Loss on Heart Failure Risk

The study found that SRT levels were significantly associated with the risk of developing heart failure among participants without hearing aids. Compared to individuals with normal hearing, those with insufficient or poor hearing had 15% and 28% increased risks, respectively. Furthermore, those using hearing aids had a 26% heightened risk of developing heart failure.

The association was even stronger for participants without a history of coronary heart disease or stroke at the study’s outset. SRT levels also correlated significantly with social isolation, psychological distress, and neuroticism, contributing to the increased risk of heart failure.

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Psychological and Social Factors as Mediators

Social isolation, psychological distress, and neuroticism were identified as key factors mediating the association between hearing loss and heart failure. Together, these factors accounted for just over 9% of the total effect. Individually, they contributed 3%, 17%, and 3%, but with overlap among them. The researchers noted that the total effect was less than the sum of the individual contributions, indicating an overlap and interaction among these factors.

While this is an observational study and cannot establish direct cause-and-effect relationships, the researchers suggest plausible biological mechanisms for their findings. They point to the cochlea’s rich capillary network and the inner ear’s high metabolic demands, which might make it more sensitive to vascular issues. Therefore, hearing impairment may serve as an early indicator of vascular health problems and predict cardiovascular diseases like heart failure.

The study emphasizes the need for integrating hearing health assessments into broader cardiovascular risk evaluations. It suggests that strengthening psychological interventions for individuals with hearing loss could help reduce the risk of heart failure. Additionally, both hearing aid users and individuals with poor hearing showed a similar increase in heart failure risk, suggesting that hearing aids may not address the underlying vascular health issues that contribute to this risk.

References:

Hearing impairment, psychological distress, and incident heart failure: a prospective cohort study - (https://heart.bmj.com/content/early/2025/04/03/heartjnl-2024-325394)
Hearing Impairment and Incident Heart Failure - (https://healthmanagement.org/c/cardio/News/hearing-impairment-and-incident-heart-failure)

Source-Medindia