Assessment of Cochlear Dysfunction in Black and White Adults with Stage 2 Hypertension Using High-Frequency Distortion Product Otoacoustic Emissions

使用高频失真产物耳声发射评估患有 2 期高血压的黑人和白人成人的耳蜗功能

• 批准号: 10652892
• 负责人: Rachael Rebecca Baiduc
• 金额: $ 20.78万
• 依托单位: UNIVERSITY OF COLORADO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-27 至 2026-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10652892
• 关键词: Acceleration; Acoustics; Acquired Deafness; Adult; Affect; African American population; Age; Age Factors; Aging; Audiology; Auditory; Behavioral; Biological; Black Populations; Black race; Blood Pressure; Cell physiology; Chronic; Chronic Disease; Clinical; Clinical Protocols; Cochlea; Data; Data Analyses; Data Collection; Development; Disease; Early Intervention; Early identification; Elderly; Enrollment; Ethnic Origin; Evaluation; Exclusion; Frequencies; Functional disorder; Future; Goals; Guidelines; Health; Hearing Tests; Hearing problem; High Prevalence; Human; Hypertension; Impaired cognition; Impairment; Individual; Intervention; Jackson Heart Study; Knowledge; Lesion; Link; Literature; Low Prevalence; Mathematics; Measurement; Measures; Medical; Melanins; Mental Depression; Methodology; Minority Groups; Minority Participation; Mission; Modeling; Monitor; National Institute on Deafness and Other Communication Disorders; Neurosciences; Noise-Induced Hearing Loss; Outcome; Outer Hair Cells; Participant; Pathogenesis; Patients; Persons; Population; Predisposition; Presbycusis; Process; Protocols documentation; Public Health; Race; Rattus; Reporting; Research; Research Personnel; Research Priority; Risk; Risk Factors; Role; Sex Differences; Site; Statistical Models; Stria Vascularis; Testing; Underserved Population; Woman; Work; aged; behavior test; burden of illness; cardiometabolic risk; cardiometabolism; cardiovascular health; clinical development; comorbidity; disability; epidemiology study; ethnic minority; experience; hearing impairment; hypertensive; improved; innovation; interest; men; modifiable risk; multidisciplinary; noise exposure; normotensive; otoacoustic emission; prospective; racial difference; racial minority; sex; therapeutically effective; tool

Little is known about the relationship between hypertension (HTN) and auditory dysfunction in the Black adult population and to what extent it differs from that in White persons. Experimental work shows the cochlea is irreversibly damaged in HTN, making early identification of cochlear dysfunction in persons with this modifiable condition critical to reducing the disease burden of age-related hearing loss (ARHL). It is also known that HTN disproportionately affects Black persons. The long-term goal of this line of research is to reduce the public health burden of ARHL by devising clinical efforts for early identification and intervention of persons with modifiable determinants of acquired hearing loss. The overall objective of this application is to assess cochlear function in Stage 2 HTN (a severe elevation in blood pressure) and characterize differences in this relationship between Black and White adults. The central hypothesis, supported by past studies and the applicant’s preliminary data, is that, compared to normotensives, outer hair cell health is compromised in persons with Stage 2 HTN and that White adults experience greater compromise than Black adults. The rationale for this work is that once the extent of auditory damage in Stage 2 HTN is determined, clinical protocols for early evaluation of auditory vulnerability in persons with HTN can be established, which will support earlier intervention. The central hypothesis will be tested by pursuing two specific aims: (1) assess functional integrity of the cochlea in persons with Stage 2 HTN and (2) characterize Black-White differences in the association between Stage 2 HTN and cochlear dysfunction. Adults aged 18-85 years with normal blood pressure (controls) or Stage 2 HTN will undergo extensive behavioral and swept-tone distortion product otoacoustic emission (DPOAE) testing. Under Aim 1, swept-tone DPOAEs will be collected from f2 of 1-20 kHz. Under Aim 2, linear mixed effects modeling will disentangle the effects of HTN, race, sex, and potential confounders on auditory function with a focus on cochlear health. Innovation aspects of this research include the methodological approach (swept-tone high-frequency DPOAEs), statistical modeling (which will disambiguate the effects of HTN from other contributors to ARHL), and assessment of racial differences. The proposed research is significant because it is a vital step in devising clinical efforts for early identification and intervention of persons with modifiable determinants of acquired hearing loss and will provide critically needed data on cochlear dysfunction in Black adults, a historically under-studied population. Capturing auditory dysfunction early in the disease process is important because hearing loss, even in the subclinical stage, is associated with negative outcomes. Ultimately, knowledge gained from this research will inform development of clinical tools and protocols to improve early identification of auditory dysfunction in persons with medical comorbidities such as Stage 2 HTN with the end goal of advancing more effective therapeutic solutions.

黑人成人中高血压（HTN）和听觉功能障碍之间的关系知之甚少 人口以及白人在多大程度上有所不同。实验工作表明耳蜗是 在HTN中受到不可逆转的损害，以这种可修改的人对耳蜗功能障碍进行了早期识别 对减少与年龄相关的听力损失（ARHL）的疾病至关重要的条件。还知道HTN 不成比例地影响黑人。这一研究的长期目标是减少公共卫生 通过制定临床努力来对具有可修改的人的早期识别和干预来制定临床努力，从而负担ARHL的负担 获得的听力损失的决定因素。该应用的总体目的是评估人工耳蜗功能 第2阶段HTN（血压严重升高），表征了这种关系的差异 黑白成年人。中央假设，由过去的研究和申请人的初步数据支持 是，与正常敏化剂相比，外部毛细胞健康受到第2阶段HTN的损害，并且 白人成年人的妥协比黑人成年人更大。这项工作的理由是一旦 确定了第2阶段HTN中听觉损害，用于早期评估听觉脆弱性的临床方案 可以建立患有HTN的人，这将支持早期的干预措施。 中心假设将通过追求两个具体目标来检验：（1）评估耳蜗的功能完整性 在阶段2 HTN和（2）的人中，在第2阶段之间的关联中表征了黑白差异 HTN和人工耳蜗功能障碍。正常血压（对照）或第2期HTN的18-85岁的成年人 将经过广泛的行为和横扫变形产物耳声发射（DPOAE）测试。 在AIM 1下，将从1-20 kHz的F2收集扫描的DPOAE。在AIM 2下，线性混合效果 建模将使HTN，种族，性别和潜在混杂因素对听觉功能的影响 专注于人工耳蜗。这项研究的创新方面包括方法论方法（扫描） 高频DPOAE），统计建模（这将使其他贡献者的影响歧义 对ARHL），并评估种族差异。拟议的研究很重要，因为这是至关重要的一步 在为临床努力进行临床努力，以对具有可修改的决定者的早期识别和干预措施 获得的听力损失，并将提供有关黑人成年人的耳蜗功能障碍的急需数据，这是历史上的 人口不足。在疾病过程的早期捕获听觉功能障碍很重要，因为 甚至在亚临床阶段，听力损失也与负面结果有关。最终，知识获得了 从这项研究中，将为开发临床工具和协议的开发，以改善对听觉的早期识别 患有医学合并症的人（例如第2阶段HTN）的功能障碍，其最终目标是推进更多 有效的治疗解决方案。