Hypertension was significantly associated with higher odds of tinnitus, with a dose-response relationship demonstrating increasing odds alongside severity and poor control of hypertension, and even controlled hypertension was associated with elevated odds compared with normotensive individuals.
Key Findings
Results
Hypertension was significantly associated with higher odds of tinnitus in the overall study population.
Adjusted OR=1.34; 95% CI 1.10 to 1.62
Study population included 9775 individuals aged 35-70 years from a rural setting in Sheshdeh, Fasa, Iran
Participants included 4446 males and 5329 females with mean age 48.55 (SD 9.53) years
Tinnitus was defined as a continuous wheezing sound in the ear persisting for more than 1 week, assessed by self-reported questionnaire
Hypertension was defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg on at least two separate measurements or current use of antihypertensive medications
Results
The prevalence of tinnitus was 7.4% and the prevalence of hypertension was 19.3% in the study population.
Tinnitus prevalence: 7.4% of the 9775 participants
Hypertension prevalence: 19.3% of the 9775 participants
Participants with history of cancer, pregnancy, stroke, seizures, or multiple sclerosis were excluded
No aminoglycoside users were identified during the study period
Results
Even participants with controlled hypertension had significantly elevated odds of tinnitus compared with normotensive individuals.
Controlled hypertension was associated with OR=1.27; 95% CI 1.02 to 1.59
This represents a 27% increased odds of tinnitus compared with normotensive individuals
Controlled blood pressure was defined as values below SBP 140 mm Hg and DBP 90 mm Hg in participants on antihypertensive medications
This finding indicates that tinnitus risk persists even when blood pressure is pharmacologically managed
Results
A dose-response relationship was observed between hypertension severity and tinnitus odds, with uncontrolled grade II hypertension showing the highest odds.
Uncontrolled grade II hypertension: OR=2.08; 95% CI 1.25 to 3.47
Stage I hypertension was classified as SBP 140-159 mm Hg or DBP 90-99 mm Hg
Stage II hypertension was defined as SBP ≥160 mm Hg or DBP ≥100 mm Hg
Odds of tinnitus increased progressively with greater severity and poorer control of hypertension, demonstrating a dose-response relationship
Methods
The study excluded individuals with medical conditions known to cause tinnitus to reduce confounding.
Exclusions included history of cancer, pregnancy, stroke, seizures, and multiple sclerosis
The study design also aimed to exclude participants using aminoglycosides due to their significant ototoxic effects, though no such users were identified
Antihypertensive medications included ACE inhibitors, angiotensin receptor blockers, diuretics, aldosterone antagonists, and atenolol
The cross-sectional observational design was used with data from a population-based cohort
Conclusions
The authors conclude that tinnitus screening may be warranted in all hypertensive patients regardless of blood pressure control status.
Even controlled hypertension was associated with elevated odds of tinnitus (OR=1.27; 95% CI 1.02 to 1.59)
Authors state findings 'underscore the need for heightened clinical awareness and further research into the pathophysiological mechanisms linking vascular health and auditory symptoms'
The findings suggest a positive association between hypertension and tinnitus across all hypertension categories examined
What This Means
This research suggests that people with high blood pressure (hypertension) are more likely to experience tinnitus — a persistent ringing or buzzing sound in the ears — compared to people with normal blood pressure. The study analyzed nearly 10,000 adults aged 35–70 from a rural area in Iran and found that having hypertension was associated with about a 34% higher chance of having tinnitus. Importantly, even people whose blood pressure was being successfully controlled with medication still had a 27% higher chance of experiencing tinnitus compared to people who never had high blood pressure.
The study also found that the worse the hypertension, the higher the odds of tinnitus — a pattern known as a dose-response relationship. People with the most severe, uncontrolled high blood pressure (Stage II) had roughly double the odds of tinnitus compared to people with normal blood pressure. This pattern held even after accounting for other factors that could explain the link.
This research suggests that the relationship between blood pressure and tinnitus is not simply about whether blood pressure is currently high or controlled — something about having hypertension, even when treated, may still affect hearing or the auditory system. This could be relevant for healthcare providers who manage hypertensive patients, as it implies that tinnitus screening might be beneficial across all patients with high blood pressure, not just those with poorly controlled or severe cases. The authors call for further research into the biological mechanisms connecting blood vessel health and auditory symptoms.
Najibi A, Bazmi S, Moradi M, Mohammadi Z, Al Kamel A, Yazdanpanah M, et al.. (2026). Association between hypertension status and severity and tinnitus: a cross-sectional analysis of the Fasa adult cohort study.. BMJ open. https://doi.org/10.1136/bmjopen-2025-109272