Frequent analgesic use linked to increased risk for tinnitus among women
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Frequent use of over-the-counter analgesics, including moderate-dose aspirin, NSAIDs and acetaminophen, were associated with an increased risk for tinnitus among women, according to findings in the Journal of General Internal Medicine.
“Limiting the use of analgesics when possible may be one way to help lower the risk for developing tinnitus,” Sharon G. Curhan, MD, ScM, an assistant professor of medicine in the Channing Division of Network Medicine at Brigham and Women’s Hospital, told Healio.
About 50 million Americans experience some form of tinnitus, she said. Of these, about 20 million people experience burdensome chronic tinnitus and about 3 million people are severely disabled by tinnitus, according to a press release.
In a longitudinal cohort study, Curhan and colleagues investigated associations between persistent tinnitus and analgesics using data from the Conservation of Hearing Study, which required registered female nurses aged 25 to 42 years to complete questionnaires at baseline and every 2 years thereafter. The participants reported their use of analgesics and any symptoms similar to ringing, roaring or buzzing in their ears or head. The data were collected through the 2009, 2013 and 2017 biennial questionnaires. In total, 1,120,936 person-years of follow-up were evaluated.
Among the total person-years, 10,452 cases of incident persistent tinnitus were reported. Compared with analgesic use of less than 1 day per week, more frequent use was associated with incident persistent tinnitus, yet risk differed by the type of analgesic used, according to the researchers. Frequent use of moderate-dose aspirin ( 325 mg), defined as 6 to 7 days per week, was associated with a 16% higher risk for tinnitus (multivariable-adjusted HR = 1.16; 95% CI, 1.03-1.32) among women aged younger than 60 years but not among older women (P = .003). However, frequent use of low-dose aspirin ( 100 mg) was not associated with a higher risk for tinnitus.
Also, Curhan and colleagues reported that frequent use of NSAIDs or acetaminophen was associated with an almost 20% higher risk for tinnitus among all women, with risk increasing in correlation with more regular use. Similarly, regular use of COX-2 inhibitors, defined as 2 or more days per week, was associated with a 21% higher risk for tinnitus.
While the risk for tinnitus was evaluated in an all-female cohort, Curhan said that she expects the findings would be similar among men.
“Millions of Americans experience tinnitus and it’s often quite disabling,” she said. “Even though it’s one of the most chronic health conditions in the U.S., it’s not something that primary care providers routinely ask about during the physical exam.”
Curham recommended that primary care providers include tinnitus and hearing health in their overall evaluation of a patient’s wellbeing. Moreover, providers should counsel patients about analgesics to mindfully limit their use as much as possible and explore nonpharmacological alternatives or complementary approaches.
References:
Curhan SG, et al. JGIM. 2022;doi:10.1007/s11606-021-07349-5.
Frequent use of over-the-counter analgesics associated with risk of tinnitus. https://www.eurekalert.org/news-releases/942764. Published Feb. 9, 2022. Accessed Feb. 10, 2022.