Tinnitus, or “ringing in your ears,” is a common chronic condition that can be seriously debilitating for a small percentage of people. Although there is no known cure for tinnitus, very effective treatments help people manage this chronic condition. In this article, we discuss what tinnitus is, some of the conditions that generate tinnitus, the specifics of tinnitus from high blood pressure, and what you can do about it.

What is Tinnitus

Tinnitus (Pronounced tin·NY·tus or TIN·ni·tus) is a neurological and audiological condition characterized by the perception of noise – like ringing, buzzing, hissing, or clicking – in your ears or head that occurs without any external source of the sound. Approximately 10 percent of adult Americans experience tinnitus, roughly 5 million of them grapple with chronic tinnitus (persisting 12 months or longer), and about 2 million find it debilitating, according to the National Institute on Deafness and Other Communication Disorders.

tinnitus from high blood pressure
Image Credit Mayo Clinic

Tinnitus is rarely associated with an underlying emergency or life-threatening condition, but it can significantly affect quality of life and wellbeing. Individuals experiencing tinnitus should seek help from experts, including hearing healthcare professionals, psychologists, and clinical social workers.

What Causes tinnitus?

Rather than a disease, tinnitus is the symptom of a condition in the auditory system, including the ear, the auditory nerve, and the auditory cortex, a portion of the brain responsible for processing sound. Tinnitus is primarily associated with hearing loss, but many conditions can produce tinnitus as a symptom, including high blood pressure.

Some of the most common conditions that can cause tinnitus as a symptom include:

  • Hearing loss
  • High blood pressure
  • Obstructions in the middle ear
  • Ear and sinus infections
  • Temporomandibular joint (TMJ) disorder
  • Head and neck trauma
  • Metabolic disorders like hypo- and hyperthyroidism
  • Autoimmune conditions like fibromyalgia and Lyme disease
  • Psychiatric conditions, including depression, stress, and anxiety
  • Vestibular disorders, including Meniere’s disease and otosclerosis

Ototoxic Medications

Tinnitus is also listed as a potential side effect of many prescription drugs. For most medications, the appearance of tinnitus is a temporary side effect that typically goes away when the patient stops taking the medication. Although, in most cases, medication-induced tinnitus is temporary, some ototoxic drugs cause permanent tinnitus symptoms, including:

  • Non-steroidal anti-inflammatory drugs
  • Some antibiotics
  • Certain chemotherapy medicines
  • Some diuretics
  • Quinine-based medications
  • Some high blood pressure medications

Important: Never stop taking a medication without first consulting your doctor.

What is High Blood Pressure

High blood pressure, a major health concern for many people worldwide, is a medical condition where the pressure of blood pushing against the walls of your arteries is higher than normal. It is defined by the American College of Cardiology and the American Heart Association as having an elevated systolic blood pressure—the top number of a blood pressure reading—higher than 130 or diastolic blood pressure—the bottom number of the reading—more than 80.

High blood pressure is referred to as a silent killer given that it can occur without any symptoms, but once present it can put individuals at higher risk for heart disease, stroke, and other health problems if left untreated.

According to the Centers for Disease Control and Prevention (CDC), Nearly half of the adults in the United States (47%, or 116 million) have high blood pressure (also known as hypertension), and only about 1 in 4 adults (24%) with hypertension have their condition under control.

Ototoxic Blood Pressure Medications

Some medications used to treat high blood pressure have been found to have the potential to be ototoxic. Below we list some of the prescription drugs that may result in tinnitus:

Beta-Blockers

Beta-blockers like Bisoprolol, Nebivolol (Bystolic), and Metoprolol reduce blood pressure by lowering the heart rate.

Alpha-Blockers

Alpha-blockers like Doxazosin lower blood pressure by relaxing the walls of the blood vessels and letting the blood flow more easily

ACE Inhibitors

Angiotensin-Converting Enzyme (ACE) inhibitors like Ramipril reduce blood pressure by prompting your body to produce less angiotensin, a naturally-occurring chemical in your body that causes your blood vessels to narrow.

Angiotensin Receptor Blockers

Angiotensin receptor blockers like Irbesartan lower blood pressure by preventing angiotensin from binding to a receptor in your body and, therefore, not allowing it to narrow your blood vessels.

“These medicines don’t always cause tinnitus in every patient. Your tinnitus may be caused by something different altogether, and it may just be a coincidence that you also happen to be taking one of these medications. Consult with your doctor before discontinuing any prescribed medication.”

Important Notice

Relationship Between Tinnitus and High Blood Pressure

There is a strong association between high blood pressure and tinnitus, with 44% of individuals with tinnitus having both high blood pressure and ears ringing, according to the National Center for Biotechnology Information.

There are two ways in which you can get tinnitus from high blood pressure:

  • Direct Relationship: When tinnitus is a direct result of high blood pressure
  • Indirect Relationship: When tinnitus is the result of other factors that involve high blood pressure

Tinnitus from High Blood Pressure – A Direct Relationship

If you are hypertense, you will likely have high ear blood pressure, as high blood pressure affects the blood vessels in your ear. This condition in itself can result in tinnitus. Although direct incidence of tinnitus from high blood pressure is not very common, treatment of the underlying high blood pressure can reduce or eliminate tinnitus.

Tinnitus from High Blood Pressure – An Indirect Relationship

Hearing loss is the number one condition associated with tinnitus. According to the Hearing Loss Association of America, 90% of Americans with tinnitus also have hearing loss. It’s important to note here that patients with tinnitus may not notice their hearing loss at first. In most cases, hearing loss occurs gradually and patients only start taking notice of it after the condition has progressed.

Patients taking ototoxic blood pressure medications may develop hearing loss – even mild hearing loss – before they show tinnitus symptoms. In this case, the hypothesis is that the blood pressure medication may be resulting in hearing loss, and the tinnitus symptoms only appear after patients have lost some of their hearing.

So, the indirect path of getting tinnitus from high blood pressure is as follows:

Patient has high blood pressure >>> Patient is treated with ototoxic medication >>> Medication results in hearing loss >>> Tinnitus develops in conjunction with hearing loss

What To Do If You Have Tinnitus

If you have ringing in your ears you may be experiencing tinnitus from high blood pressure and you should seek help from a doctor and a hearing healthcare professional. These experts will likely physically examine your head, neck, and ears, check your blood pressure and test your hearing to determine whether you have hearing loss. These professionals may recommend that you enlist the help of other expert professionals, including psychologists, psychiatrists, and clinical social workers, as most successful tinnitus interventions involve a combination of treatment options.

Tinnitus Treatment Options

Tinnitus does not have a scientifically-validated cure yet. If you have tinnitus from high blood pressure, getting your blood pressure under control may reduce or eliminate your tinnitus. If that is not the case, then your hearing healthcare professional has many effective options to treat your tinnitus and help you lead a happy and successful life while managing your condition.

  • Hearing Aids are very helpful for people who have hearing loss and tinnitus: A survey of 230 hearing care professionals suggests that six out of 10 patients (60%) experienced minor to major relief of tinnitus when wearing hearing aids, and a total of one in five (22%) receive major relief.
  • Counseling Programs help patients learn how to live with their tinnitus, including how to think about it, how to react to it, and how to make it less noticeable.
  • Sound Generators can be small, wearable devices or tabletop units that use various sounds to mask tinnitus.
  • Acoustic Neural Stimulation is a relatively new technique that delivers a broadband acoustic signal embedded in music to help stimulate change in the neural circuits in the brain, which eventually desensitizes you to tinnitus.
  • Sensory Substitution Stimulation is a novel approach involving a wristband coupled with a smartphone app that uses sounds and vibrations to teach the brain which sounds are real (external) and which are self-generated (internal).
  • Antidepressants and Antianxiety Medicines might be prescribed by your doctor to improve your mood and help you sleep.

Tinnitus from High Blood Pressure – Conclusion

Although there is no known cure for tinnitus yet, there are many effective treatment options that help people manage this condition. Tinnitus from high blood pressure is a common occurrence: If you have tinnitus, there is a 44% chance that it is related to high blood pressure.

Talk with your doctor and hearing healthcare professional about tinnitus and high blood pressure. Also, have a conversation with them about any ototoxic prescription drugs you may be taking. If your tinnitus is persistent, look to engage other experts and explore what combination of treatments is right for you!

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In addition to being the Founder and Editor-in Chief at HearingPeople.com, Luis Zuluaga is the founder and CEO of Florida Hearing Institute, an innovative hearing health enterprise in South Florida, focused on bringing high-tech hearing devices at affordable prices to people with hearing loss. Before his latest hearing healthcare endeavors, Luis served as President and Chief Operating Officer of Zounds Hearing Inc., a US-based hearing aid manufacturer that introduced many technical innovations to the hearing aid market.

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