Association of beta blocker use and hearing ability in adults: a cross-sectional study.

OBJECTIVES: To investigate the potential association between beta blocker use and hearing ability in adults and to discern whether this effect is dose-dependent. DESIGN: Cross-sectional analyses. Multiple linear regression was performed with hearing ability as the dependent variable and beta blocker use as the independent variable. The independent variable was classified into three dose categories for secondary analysis. Adjustments were made for age, gender, educational level, and tobacco smoking status. STUDY SAMPLE: 1636 adults, 75 of whom reported being on beta blockers, from the internet-based Netherlands Longitudinal Study on Hearing (NL-SH). RESULTS: No significant association was found between beta blocker use and hearing ability in noise. In the adjusted regressions, beta blocker use changed the speech reception threshold in noise (SRT) by -0.04 dB signal-to-noise ratio (SNR) (95%CI [-0.67 to 0.58], p = 0.890). Medium dose beta blocker use changed SRT by -0.42 dB SNR (95%CI [-1.38 to 0.71], p = 0.433), while a high dose changed it by -0.26 dB SNR (95%CI [-1.74 to 1.4], p = 0.767). CONCLUSIONS: No evidence was found for beta blocker-induced changes in hearing ability. Future studies on this topic should favour case-control and cohort study designs, while focussing on a hypertensive population to minimise confounding by indication.

Treatment of canine pulmonary arterial hypertension: is tadalafil an appropriate alternative to sildenafil?

The drugs tadalafil and sildenafil share the same mechanism. Although more research is necessary to solidify the recommendation of the routine use of tadalafil, human and dog data combined with pharmacokinetic data suggest that dogs may be safely treated for canine pulmonary arterial hypertension with tadalafil for the convenience of less frequent dosing, with effects similar to sildenafil. While more costly, the use of tadalafil has positive implications in improving compliance and, therefore, therapeutic outcomes in canine pulmonary arterial hypertension. This article explores the data for the use of tadalafil in canine pulmonary arterial hypertension and provides example compounded preparations.