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.

关于黑人成人高血压（HTN）和听觉功能障碍之间的关系知之甚少 人口以及它与白人的不同程度。实验工作表明耳蜗是。 HTN 中不可逆转的损伤，使得早期识别患有这种可改变的人的耳蜗功能障碍 众所周知，HTN 是减轻年龄相关性听力损失 (ARHL) 疾病负担的关键疾病。 这方面研究的长期目标是减少公众健康。 通过设计临床工作来早期识别和干预可改变的人，以减轻 ARHL 的负担 该应用程序的总体目标是评估耳蜗功能。 第 2 阶段 HTN（血压严重升高）以及描述之间这种关系的差异 黑人和白人成年人的中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 期高血压的人的外毛细胞健康受到损害，并且 白人成年人比黑人成年人经历了更大的妥协。这项工作的理由是，一旦达到了程度。 确定 2 期 HTN 听觉损伤的严重程度，以及早期评估听觉脆弱性的临床方案 可以确定患有高血压的人的情况，这将支持早期干预。 将通过追求两个具体目标来检验中心假设：（1）评估耳蜗的功能完整性 患有第 2 阶段 HTN 的人以及 (2) 表征第 2 阶段之间关联的黑人与白人之间的差异 HTN 和耳蜗功能障碍，血压正常（对照）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。 在目标 1 下，将从 1-20 kHz 的 f2 收集扫频 DPOAE，在目标 2 下，线性混合效果。 建模将阐明 HTN、种族、性别和潜在混杂因素对听觉功能的影响 这项研究的创新方面包括方法论（扫频）。 高频 DPOAE）、统计模型（这将消除 HTN 与其他贡献者的影响） ARHL），并且对种族差异的评估很重要，因为这是至关重要的一步。 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，并将提供有关黑人成人耳蜗功能障碍的急需数据，这是历史上的一个 在疾病过程的早期捕获听觉功能障碍很重要，因为 听力损失，即使在亚临床阶段，最终也会带来负面结果。 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 患有合并症（例如 2 期高血压）的人的功能障碍，最终目标是推进更多 有效的治疗解决方案。