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.

黑人成年人中高血压(HTN)与听力障碍之间的关系知之甚少 以及在多大程度上不同于白人。实验工作表明，耳蜗是 HTN的不可逆性损害，使患有这种疾病的人早期识别耳蜗功能障碍 对于减少年龄相关性听力损失(ARHL)的疾病负担至关重要的情况。还有一点是众所周知的，HTN 不成比例地影响黑人。这项研究的长期目标是减少公众健康 通过设计临床工作以早期识别和干预可改变的患者来减轻ARHL的负担 获得性听力损失的决定因素。这项应用的总体目标是评估耳聋患者的耳蜗功能 2期HTN(一种严重的血压升高)和表征这种关系之间的差异 黑人和白人成年人。核心假设得到了过去的研究和申请人的初步数据的支持， 与血压正常的人相比，患有2期HTN的人的外毛细胞健康受到损害，而且 白人成年人比黑人成年人经历了更大的妥协。这项工作的基本原理是，一旦范围 确定2期HTN中听力损害的可能性，早期评估听力易损性的临床方案 可以在HTN患者中建立，这将支持早期干预。 中心假设将通过追求两个具体目标来检验：(1)评估耳蜗骨的功能完整性 在患有第二阶段HTN的人中，(2)表征第二阶段之间联系的黑白差异 HTN与耳蜗机能障碍。血压正常(对照组)或2期HTN的18-85岁成年人 将接受广泛的行为和扫频失真产物耳声发射(DPOAE)测试。 根据目标1，扫频DPOAE将从1-20 kHz的f2中收集。在目标2下，线性混合效果 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 重点关注耳蜗病的健康。本研究的创新之处包括方法论方法(扫调 高频DPOAE)、统计建模(这将消除HTN与其他贡献者之间的影响 ARHL)，以及种族差异评估。这项拟议的研究意义重大，因为它是至关重要的一步。 在设计临床工作以早期识别和干预具有可改变的决定因素的人 获得性听力损失，并将提供急需的数据关于黑人成年人的耳蜗功能障碍，历史上 研究不足的人群。在疾病过程的早期捕捉到听觉功能障碍很重要，因为 听力损失，即使是在亚临床阶段，也与负面结果有关。最终，所获得的知识 这项研究将为临床工具和方案的开发提供信息，以改进听力早期识别 患有内科合并症的人的功能障碍，如2期HTN，最终目标是进展更多 有效的治疗方案。