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.

黑人成年人高血压与听觉功能障碍的关系尚不清楚 人口以及在多大程度上它不同于白色人。实验工作表明，耳蜗是 在HTN中不可逆地受损，使早期识别耳蜗功能障碍的人，这种可改变的 对于减少年龄相关性听力损失（ARHL）的疾病负担至关重要。据了解，HTN 对黑人的影响不成比例。这项研究的长期目标是减少公众健康 通过设计临床工作，早期识别和干预可改变的ARHL患者， 后天性听力损失的决定因素。本申请的总体目标是评估耳蜗功能， 2期HTN（血压严重升高），并描述 黑人和白色成年人。中心假设得到了过去研究和申请人初步数据的支持， 与血压正常者相比，2期HTN患者的外毛细胞健康受损， 白色成年人比黑人成年人经历更大的妥协。这项工作的基本原理是，一旦程度 听力损害的第2阶段HTN的确定，临床方案的早期评估听觉脆弱性 在HTN患者中，可以建立，这将支持早期干预。 中心假设将通过追求两个具体目标进行测试：（1）评估耳蜗功能的完整性 在患有2期HTN的人中，（2）表征2期HTN之间的关联中的黑白差异 HTN和耳蜗功能障碍。18 - 85岁的正常血压（对照）或2期HTN成人 将接受广泛的行为和扫频失真产物耳声发射（DPOAE）测试。 在目标1下，将从1 - 20 kHz的f2采集扫频DPOAE。在目标2下，线性混合效应 建模将解开HTN，种族，性别和潜在混杂因素对听觉功能的影响， 关注耳蜗健康本研究的创新之处在于方法论上的创新（扫音 高频DPOAEs）、统计建模（这将消除HTN与其他贡献者的影响 #21453;，以及种族差异的评估。拟议的研究是重要的，因为它是一个至关重要的步骤 在设计临床努力，早期识别和干预的人与可变的决定因素， 获得性听力损失，并将提供急需的数据耳蜗功能障碍的黑人成年人，一个历史上 研究人群。在疾病过程的早期捕获听觉功能障碍是重要的，因为 听力损失，即使在亚临床阶段，也与负面结果有关。最终，知识获得了 这项研究将为临床工具和方案的开发提供信息，以改善听觉障碍的早期识别。 患有医学共病（如2期HTN）的患者的功能障碍，最终目标是促进更多 有效的治疗方案。