Can Heart Disease Cause Ringing in the Ears?

Heart disease comes with a slew of side effects and symptoms, some of which may not initially seem related. Because Cardiovascular Disease (CVD) is a condition impacting blood flow, most often paired with high blood pressure and other circulatory effects, it can cause issues elsewhere in the body, including the ears. Maintaining heart health is critical in managing overall health. It can also be a vital way to avoid risk factors involving immune health, hearing health, and can even impact the likelihood of seemingly unrelated issues, like developing symptoms associated with a recurring ear infection. How exactly does heart disease impact the inner ear? To understand that, we must first identify what heart disease is and how a healthy cardiovascular system impacts the health of the ear.

What Is Heart Disease?

Heart disease is an umbrella term used to describe many different conditions related to the heart and blood vessels. Although it is often used as a singular description of disease, there are several different types of conditions that qualify as potential catalysts for heart failure and other heart-related concerns. Additional conditions that fall under “coronary heart disease” and related terms include:

• Blood vessel diseases
• Coronary artery disease
• Irregular heartbeats (arrhythmia)
• Diseases of the heart muscle or heart valves

The larger category of heart disease is the leading cause of death in the United States as of the time of this writing, according to the CDC, which means that it is a serious matter for public health and policy. The intersection of cardiovascular problems and hearing concerns may impact more people than many people realize. Whether it means using hearing aids or experiencing disruptions to sound waves and subsequent difficulty discerning sounds, there is too much evidence to ignore that heart conditions can in some way impact the health of the ear and its ability to properly hear.

Is Tinnitus Associated With Higher Incidence of Cardiovascular Disease?

The precise relationship between CVD and tinnitus is not yet known; that is to say, developing heart disease may not cause tinnitus, and tinnitus may not indicate the presence of CVD. Instead, it means that there is a relationship between the conditions, and the two may possess similar risk factors. A Swedish study conducted in 2020 evaluated different comorbid conditions that existed alongside tinnitus in a sample of over 7,000 people. This study determined that there was an observed relationship between CVD and tinnitus, as well as numerous other conditions that impacted hearing health and the inner ear.

Another study, conducted a decade earlier, parsed through decades of research evaluating hearing loss and heart disease and determined that a relationship was consistently found between the two, suggesting that CVD was potentially involved in sudden sensorineural hearing loss and other conditions of the inner ear.

While these studies do not definitively determine that heart disease is directly involved in hearing health, they do suggest that conditions impacting blood flow may be related to hearing loss and other conditions that involve hearing impairment or changes to the middle ear. With that relationship more thoroughly understood, it may be possible to associate poor circulation and health conditions involving the heart with hearing loss or low scores on a hearing test, and may also be possible to lower blood pressure and improve heart health as a means of supporting ear health and limiting hearing problems related to blood flow.

To understand the relationship between hearing loss and blood flow, one study focused on the relationship between impaired blood supply to the cochlea and subsequent damage to the cochlea’s structure and auditory nerve cell bodies. Damage to these structures, including the small, hair-like cells that help transfer sound energy to the auditory nerve, can lead to hearing loss and tinnitus symptoms. The results of this study found that there may be a mechanism of action between CVD and tinnitus, suggesting that hearing loss and damage can be positively impacted by improving the health of the heart when the heart is able to pump blood effectively throughout the body–including the ears.

Can Pulsatile Tinnitus Be Related to Cardiovascular Disease?

A very particular type of tinnitus, called pulsatile tinnitus (PT), presents as hearing a “whooshing” or beating sound in time with your heartbeat. While not specifically identified as a type of acute hearing loss, this type of tinnitus can cause a sensation of hearing loss through a type of tunnel-like concentration of sound that may be obscured by loud noises and other distracting elements.

In some cases, abnormalities in blood vessels, such as narrowing, can be identified as the source of the sound, due to the forceful flow of blood through blood vessels. In others, PT may be the result of vessels being in close proximity to the ear. Because PT can also be caused by tumors with rich blood supply near the ear or that arise as a result of cardiovascular damage or concerns, symptoms should not be ignored and necessitate a visit with your medical provider.

Can Exercise Help?

Some research has suggested a positive relationship between improved or well-maintained health of the cardiovascular system and the integrity of your hearing health. This study focused on high blood pressure and other factors impacting cardiovascular health, and did not hone in on tinnitus in particular. Additionally, the study found a correlation, but did not identify causation; further research is needed to determine the type of relationship between a healthy heart and hearing, and whether that relationship is a causal one.

In this particular study, heart health was largely determined by physical activity levels, though a balanced diet should certainly not be overlooked. Because there are a host of health benefits linked to exercise, even in the absence of a definitive link to heart health conditions and hearing loss, it may be worth considering increasing your activity level to support your heart, reduce the risk of CVDs like valvular heart disease, and even more effectively support your hearing.

It is important to consult your primary care provider before beginning an exercise program, particularly if a congenital heart defect is known or suspected, if you are at risk for a heart attack, or you have any existing condition known to restrict blood flow to reap the benefits of exercise without increasing the risk of injury or harm. An adequate oxygen supply is essential to safely exercise, so it is important to make sure you are not overtaxing your body while exercising.

Summary

Studies have found that CVD and tinnitus may be related, though the precise nature of the relationship has not yet been determined. Those studies found a correlation between the presence of heart diseases and tinnitus, but did not determine whether the central auditory system was directly impacted by atherosclerotic disease and other, similar heart conditions. Because some forms of tinnitus (including PT) have been tied to serious health concerns, any tinnitus accompanied by a whooshing sound or a beat that matches the beat of your heart should be examined by a medical professional, to rule out the likelihood of a serious condition or to seek tinnitus treatment.

Although it is always a good idea to make healthy lifestyle choices to support heart health, exercise alone should not be considered a means of treatment for heart arrhythmias and other heart disease and conditions. All concerns about heart health should be discussed with a physician, including the sudden onset of tinnitus or other loss of hearing, chest pain, and other symptoms associated with damage to the heart or arteries. Tinnitus and hearing loss are both associated with older adults, but people of all ages can experience tinnitus symptoms, and try to get ahead of any cardiovascular health problems by evaluating the root cause of those hearing issues and engaging in healthy lifestyle habits.

Regular exercise has not been identified as an effective means of treatment for tinnitus, but it is typically recommended for those with dilated cardiomyopathy and other heart conditions, provided that those exercises are supportive of the heart rather than stressful. It may not yet be clear whether or not heart health directly impacts hearing, but high cholesterol, high blood pressure, arterial build up, and other cardiovascular system concerns may be linked to hearing loss and hearing concerns like tinnitus. A gentle exercise program can function as a supportive action in maintaining overall health and well being, which may include the health of the delicate hair cells found within the auditory system that are impacted by receiving adequate blood flow.

Because studies have not conclusively determined that tinnitus and the loss of hearing are definitively linked to decreases in the health of the heart and circulatory system, it is not possible to rule out family history and other factors as more significant determiners of tinnitus onset. Nevertheless, there are some ties consistently identified between the health of the heart and the maintenance of inner ear function, making it important to support both systems to ensure optimal health in each.