Associação entre zumbido e hipertensão arterial
Data
2015-10-28
Autores
Figueiredo, Ricardo Rodrigues 
Orientadores
Penido, Norma de Oliveira
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O zumbido, a percepção de um ruído não associado a um estímulo acústico externo, é considerado pela maioria dos autores como um sintoma de origem multifatorial. Uma revisão sistemática sobre a associação entre zumbido e hipertensão arterial sistêmica (HAS) retornou indícios de uma associação positiva, sem que se tenha encontrado uma análise detalhada do tema. Objetivos: Verificar a presença e as características do zumbido nos pacientes hipertensos. Verificar diferenças no impacto causado pelo zumbido, bem como em suas características psicoacústicas, em pacientes normo e hipertensos e avaliar a associação entre a presença de zumbido e as diversas medicações antihipertensivas utilizadas. Método: Estudo caso-controle transversal, comparando dois grupos de indivíduos, com e sem zumbido, em um total de 284 indivíduos (144 no grupo de casos e 140 no grupo-controle). Também foram comparadas características demográficas, clínicas, audiométricas e psicoacústicas do zumbido entre pacientes normo e hipertensos. Resultados: A prevalência encontrada de hipertensão nos pacientes com zumbido foi de 44,4% contra 31,4% em indivíduos sem zumbido (p=0,024). A idade dos pacientes com zumbido e HAS foi significativamente maior do que a idade dos pacientes com zumbido sem HAS (mediana de 66 do grupo com zumbido contra 52,5 do grupo sem zumbido, p=0,0001). Foram encontradas associações positivas com a presença de zumbido nos pacientes em uso de inibidores da enzima de conversão da angiotensina ( p=0,006), diuréticos tiazídicos (p<0,0001), diuréticos poupadores de potássio ( p=0,016) e bloqueadores de canais de cálcio (p=0,004). Conclusões: Existe associação entre hipertensão arterial sistêmica e zumbido. Essa associação é intensificada pelo aumento da idade, sem ser influenciada pelos fatores sexo e raça. Existe tendência estatística de associação entre a presença concomitante de HAS e diabetes mellitus e a presença de zumbido. O consumo de cafeína é maior nos pacientes sem zumbido. O uso de diuréticos, inibidores da enzima de conversão da angiotensina e bloqueadores dos canais de cálcio foi mais prevalente nos pacientes com zumbido. Não há diferenças entre as características audiométricas, psicoacústicas e o incômodo gerado pelo zumbido entre hipertensos e normotensos
Introduction: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multi-factorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension (SAH) retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. Purpose: To analyze the presence and characteristics of tinnitus in hypertensive patients. To analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed. Method: Cross-sectional transversal study, comparing two groups of subjects (144 in the study group with tinnitus and 140 in the control group, without tinnitus). Clinical, demographical, audiometric and psychoacoustics characteristics of the subjects were compared. Results: Hypertension prevalence in tinnitus subjects was 44.4% against 31.4% in subjects without tinnitus (p=0.024). Age was significantly higher for patients with tinnitus and hypertension (median of 66 for the group with tinnitus and hypertension against 52.5 for the group with hypertension only - p=0.0001). Positive associations with tinnitus were found with hypertension treatment with angiotensin-converting enzyme inhibitors ( p=0.006), thiazidic diuretics (p<0.0001), potassium-sparing diuretics ( p=0.016) and calcium channels blockers (p=0.004). Conclusions: There is an association between systemic arterial hypertension and tinnitus. This association increases with age, but is not influenced by sex and race. There is a statistical tendency to an association between the concomitancy of hypertension and diabetes mellitus and the presence of tinnitus. Caffeine consumption is higher among patients without tinnitus. Hypertension treatment with thiazidic diuretics, angiotensin-converting enzyme inhibitors and calcium channels blockers was more prevalent in tinnitus patients. Audiometric and psychoacoustical findings, as well as THI and VAS scores are similar in both hypertensive and normotensive patients with tinnitus.
Introduction: Tinnitus is the perception of noise in the absence of an external source and is considered by most authors as a multi-factorial symptom. A systematic review concerning the association of tinnitus and systemic arterial hypertension (SAH) retrieved suggestions of a positive association, but the articles included failed to perform a detailed analysis on the theme. Purpose: To analyze the presence and characteristics of tinnitus in hypertensive patients. To analyze differences between tinnitus impact and psychoacoustic measurements in hypertensive and normotensive patients and to evaluate the association between the presence of tinnitus and the diverse antihypertensive drugs employed. Method: Cross-sectional transversal study, comparing two groups of subjects (144 in the study group with tinnitus and 140 in the control group, without tinnitus). Clinical, demographical, audiometric and psychoacoustics characteristics of the subjects were compared. Results: Hypertension prevalence in tinnitus subjects was 44.4% against 31.4% in subjects without tinnitus (p=0.024). Age was significantly higher for patients with tinnitus and hypertension (median of 66 for the group with tinnitus and hypertension against 52.5 for the group with hypertension only - p=0.0001). Positive associations with tinnitus were found with hypertension treatment with angiotensin-converting enzyme inhibitors ( p=0.006), thiazidic diuretics (p<0.0001), potassium-sparing diuretics ( p=0.016) and calcium channels blockers (p=0.004). Conclusions: There is an association between systemic arterial hypertension and tinnitus. This association increases with age, but is not influenced by sex and race. There is a statistical tendency to an association between the concomitancy of hypertension and diabetes mellitus and the presence of tinnitus. Caffeine consumption is higher among patients without tinnitus. Hypertension treatment with thiazidic diuretics, angiotensin-converting enzyme inhibitors and calcium channels blockers was more prevalent in tinnitus patients. Audiometric and psychoacoustical findings, as well as THI and VAS scores are similar in both hypertensive and normotensive patients with tinnitus.
Descrição
Citação
FIGUEIREDO, Ricardo Rodrigues. Associação entre zumbido e hipertensão arterial. 2015. 104 f. Tese (Doutorado em Otorrinolaringologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2015.