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Association Between Tinnitus and Angina Pectoris in U.S. Adults: Evidence from NHANES 2009–2018
Journal article   Open access   Peer reviewed

Association Between Tinnitus and Angina Pectoris in U.S. Adults: Evidence from NHANES 2009–2018

Mitra Britton and Ishan Sunilkumar Bhatt
Audiology research (Pavia, Italy), Vol.16(2), 35
02/28/2026
DOI: 10.3390/audiolres16020035
PMCID: PMC13010772
PMID: 41874068
url
https://doi.org/10.3390/audiolres16020035View
Published (Version of record) Open Access

Abstract

Background/Objectives: Tinnitus has been increasingly associated with cardiovascular disease, and recent phenome-wide analyses have identified angina pectoris as a condition linked to tinnitus. This study aimed to replicate and quantify the association between tinnitus and angina pectoris in a nationally representative U.S. adult sample using NHANES, while adjusting for key demographic, cardiovascular, and tinnitus-related risk factors. Methods: Using data from four NHANES cycles 2009–2018, a cross-sectional analysis was conducted, which included 9185 participants, and used multivariate logistic regression analyses to investigate the association between tinnitus and angina pectoris. Results: Among 9185 adults, angina was associated with higher odds of tinnitus in all models. In the crude model, OR = 3.30 (95% CI: 2.18–4.91, p < 0.001); partially adjusted, OR = 1.92 (95% CI: 1.27–2.89, p = 0.002); fully adjusted, OR = 1.65 (95% CI: 1.07–2.55, p = 0.026). In the fully adjusted model, hearing loss (OR = 4.11), noise exposure (OR = 1.63), current smoking (OR = 1.29), older age (OR = 1.01 per year), and total cholesterol (OR = 1.003 per mg/dL) were additional significant predictors for tinnitus. Conclusions: In this nationally representative sample of U.S. adults, tinnitus was more frequently reported among individuals with a history of angina pectoris, and this association persisted after adjustment for demographic factors, socioeconomic status, hearing loss, noise exposure, smoking, and cardiometabolic comorbidities. These findings support emerging evidence that cardiovascular conditions may be associated with tinnitus, potentially reflecting shared vascular or systemic mechanisms. Given the cross-sectional design, causal inferences cannot be drawn, and the temporal relationship between angina and tinnitus remains unclear. Future longitudinal studies are needed to clarify underlying mechanisms, assess directionality, and determine whether cardiovascular risk modification may have implications for tinnitus prevention or management.

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