The relationship between BP meds and tinnitus

Dear Dr. Roach: I recently spent time with a seasoned hearing-impaired citizen. She told me that tinnitus is sometimes caused by prescription meds, especially those for high blood pressure.

I have been taking 25 milligrams of losartan, one per day in the morning for about 15 years. About five years ago, my tinnitus began. Lately, it seems to have become worse.

Do you think there is a connection? Is there another blood pressure med I could take that does not have this side effect? — F.A.C.

Dear F.A.C.: Tinnitus is a sensation of noise in or near the head in absence of an external cause. Tinnitus and hearing loss always (or nearly so) go together, but there is a long list of medicines that can cause tinnitus, which is thought to be caused by damage to the organ of hearing or to the nerve.

I have done some research suggesting that angiotensin receptor blockers like losartan have a lower risk of tinnitus compared with other blood pressure drugs.

I don’t think changing medicines from losartan is likely to help your tinnitus, and you should never stop a medicine without discussing with your doctor.

I should note that pulsatile tinnitus — when the sound one hears is not a constant tone, but rather a sound that pulses in time with the heartbeat — is sometimes associated with an aneurysm.

This should have an evaluation.

Since your symptoms have been present for so long, I would recommend an evaluation of your hearing. The American Tinnitus Association includes lots of information on its website, ata.org.