Tinnitus refers to the perception of sounds in the ear that aren’t coming from the external environment. They may sound like a buzzing, pulsing, clicking, hissing, roaring, rushing or, most commonly, ringing. Other people cannot hear most tinnitus sounds. This is called subjective tinnitus. Objective tinnitus is uncommon and defined as a sound that arises from an “objective” source, such as a defect in bodily structures near the ear or a specific sound source. An outside observer such as an audiologist or examiner can hear it under favourable conditions. Objective tinnitus is usually caused by disorders affecting the vascular or muscular system. A diagnosis of objective tinnitus is tied to how well the objective (outside) listener tries to hear the sound in question. Because of this variable, some clinicians now refer to tinnitus as either rhythmic or non-rhythmic.
Blood pressure is the force of blood pushing against the walls of your blood vessels and is measured by two numbers divided by a slash (ex. 120/80). The top number represents the systolic pressure when your heart beats. The bottom number represents diastolic blood pressure, the pressure when the heart rests between beats. High blood pressure is defined as systolic pressure over 130 or diastolic pressure over 80.
If you have tinnitus and high blood pressure, the two can be linked.
In people with high blood pressure, tinnitus is a commonly reported complaint. Research published in the NCBI found that 44.4% of people with tinnitus also had hypertension.
The connection between the two conditions relates to the delicate network of vessels in your auditory system. When pressure builds in this system, it can result in tinnitus symptoms.
If your tinnitus symptoms include a beating, pulsing or pumping sound, it is more likely to be related to your blood pressure. We recommend that you speak to your primary healthcare physician.
There are three main potential links between high blood pressure and tinnitus:
- Medication used to treat high blood pressure
- Stress and anxiety
- Circulatory issues leading to high blood pressure
Medications
The main potential tinnitus-causing medications prescribed for high blood pressure are loop diuretics. However, loop diuretics typically only cause tinnitus at high dosages. The low to moderate doses used to treat hypertension should not cause tinnitus.
Some people use aspirin to control their blood pressure and prevent heart attacks, as it is a blood-thinning medication. Aspirin can cause temporary tinnitus in very high doses. Generally, a daily aspirin prescription involves low doses that do not reach the levels required to provoke tinnitus. However, some people may be more sensitive to medications.
Stress and anxiety
Stress and anxiety are known contributors to high blood pressure and tinnitus. In stressful situations, the body produces hormones that increase blood pressure which may increase activity in the auditory nervous system.
People with anxiety tend to focus more on their tinnitus, causing the perception of the sounds to become stronger. As part of tinnitus treatment, patients are encouraged to distract themselves with sound therapy. Over time, the neural connections get weaker, and the perceived sounds decrease.
Tinnitus may become a stressor that produces high blood pressure. It can be a vicious cycle! Some clients may benefit from Tinnitus Retraining Therapy or Cognitive Behavioural therapy. Both are intended to help them understand their tinnitus and gain a sense of control over their symptoms.
Those with post-traumatic stress disorder have a higher risk of severe tinnitus, so for this group, proper PTSD treatment is essential in conjunction with Tinnitus Retraining Therapy.
Circulatory system dysfunction
High or low blood pressure can cause changes to your blood viscosity. Your blood viscosity is the measurement of the thickness and stickiness of your blood, determining how easily blood flows through the blood vessels.
An increased blood viscosity (sometimes associated with high blood pressure) can mean less blood flows through the capillaries supplying your inner ear structures. As a result, less oxygen reaches this part of your ear which can lead to hearing loss.
The inner ear can become damaged over time if this blood supply does not work well. Therefore, circulatory problems leading to high blood pressure can also contribute to tinnitus.
Pulsatile tinnitus, which seems timed to a heartbeat, specifically points to a vascular problem. People with pulsatile tinnitus need to seek medical attention.
What Are My Treatment Options?
If an underlying health issue does not cause your tinnitus or if your physician has addressed additional health issues, an audiologist may be able to provide or appropriately refer for the following treatment options:
Tinnitus Retraining Therapy (TRT): A treatment based on the neurophysiological theory that suggests the brain needs to habituate to the sound of tinnitus so that patients re no longer bothered by their tinnitus.
Cognitive-behavioural therapy (CBT): CBT works to reduce or mitigate one’s negative response to tinnitus.
Hearing Aids: We may also recommend trying a hearing aid with a tinnitus masker. This type of hearing aid will help with the user’s hearing loss to better perceive external sounds while distracting the user from whistling or buzzing with pleasant sounds.
How your tinnitus is treated will depend on the underlying cause. If your tinnitus results from high blood pressure, your primary healthcare physician may prescribe various hypertension treatments.
These could include:
- Mindfulness-based stress reduction therapies
- Engaging in regular exercise
- Eating a healthy diet
- Reducing your intake of caffeine
- Seeking counselling for anxiety and stress
- Quitting smoking
- Reducing salt in your diet
- Taking any prescribed medications as directed
Other conditions that can cause tinnitus include:
- Earwax buildup
- Ototoxic medication
- Exposure to loud noise
- Ear infection
- Allergies
- Migraines and/or headaches
- High blood pressure
- Hearing loss, TMJ, head injury,
Some things to consider if you suffer from tinnitus:
Caffeine – A big influencer that can raise blood pressure. You may also find that too much caffeine changes your sleeping habits.
Poor sleeping habits – Mom was right – eight hours of sleep every night is best. Plenty of sleep can help avoid tinnitus triggers and offers a wide array of other health benefits.
Harmful blood pressure levels – Keeping track of your blood pressure can also help protect you from other illnesses. But knowing when your blood pressure has fluctuated could tell you when your tinnitus may worsen.
Alcohol – A glass of red wine is good for your heart? We all hope this research is correct! But when it comes to alcohol and tinnitus, drinking too much alcohol increases your blood pressure, which makes the ringing more evident for many people.
Smoking – Smoking, like alcohol and caffeine, is another known cause of high blood pressure. Moreover, it can shrink the blood vessels in the ears, making tinnitus symptoms more severe.
Stress – Our body produces a surge of hormones when in a stressful situation. These hormones temporarily increase your blood pressure by causing your heart to beat faster and your blood vessels to narrow.
Tinnitus is generally an indication of an underlying health problem. And up to 90% of individuals with tinnitus also have a hearing loss.
There is no need to “learn to live” with tinnitus. In fact, it could be dangerous to ignore it. If you are experiencing tinnitus symptoms, we recommend booking an appointment with Lakeside Hearing today.
We’re here to help you throughout your hearing health journey from hearing assessments, hearing protection, hearing aids and hearing accessories, plus so much more!
References:
- (n.d.). Positive Association between Tinnitus and Arterial Hypertension. Retrieved from National Library of Medicine – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5050200/
- (n.d.). Stress and high blood pressure: What’s the connection? Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/stress-and-high-blood-pressure/art-20044190
- (n.d.). Tinnitus and high blood pressure: what’s the link? Retrieved from Specsavers: https://www.specsavers.co.uk/hearing/ear-health/tinnitus/tinnitus-high-blood-pressure
- (n.d.). Are Ringing Ears a Sign of High Blood Pressure? Retrieved from Anderson Audiology: https://andersonaudiology.com/are-ringing-ears-a-sign-of-high-blood-pressure/
