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Abstract: In clinical practice, tinnitus is a common early symptom of hypertension, and when it suddenly appears, one needs to be alert to the presence of hypertension. This patient presented to the clinic with persistent tinnitus, and after examination, the patient was found to have elevated blood pressure and was diagnosed with hypertensive disease. After aggressive medication and lifestyle improvement, the patient’s tinnitus symptoms have largely disappeared and his blood pressure has gradually decreased and stabilized.
Basic information】Male, 51 years old
Disease Type】Hypertension
Hospital】The First Affiliated Hospital of Anhui Medical University
Date of consultation】January 2022
Treatment Plan】Medication (Irbesartan Hydrochlorothiazide Tablets) + Lifestyle Improvement
Treatment Period】5 days of inpatient treatment and outpatient follow up
Effectiveness of treatment】No more tinnitus, blood pressure gradually decreased and stabilized
I. Initial consultation
Patient’s description: Tinnitus suddenly appeared 3 days ago, with an intermittent buzzing sound in the ear that lasted for several minutes. The doctor conducted relevant examinations on the patient, such as hearing screening and ear CT, and no significant abnormalities were found. The patient’s blood pressure was measured again and the result was 156/102 mmHg. The patient was clear and in general spirits, the heart borders were not large and the heart rhythm was neat. The patient was initially judged to be hypertensive, and was admitted to the hospital for treatment.
II. Treatment history
During hospitalization, the patient’s routine blood tests, liver and kidney function tests, blood glucose tests, lipid tests, and electrocardiogram tests were completed, and no abnormalities were found. Subsequently, the patient’s blood pressure was measured continuously for several times at intervals, and the values reached about 150/100 mmHg, which was diagnosed as hypertension grade 2. Considering the patient’s usual salty diet, a compound preparation with diuretics was selected for treatment, i.e., the patient was given Irbesartan hydrochlorothiazide tablets to lower blood pressure, and electrolytes were rechecked without abnormalities during hospitalization.
III. Treatment effect
On the day of admission, the patient’s blood pressure was monitored several times, and the values were all around 150/100mmhg. On the second day after medication, the patient’s blood pressure was controlled at about 140/90 mmHg, tinnitus episodes were reduced, and the patient felt relief from his symptoms. After 5 days of treatment, the patient’s blood pressure was stable at about 140/80mmHg, and the tinnitus symptoms basically disappeared, and the electrolytes were rechecked on the same day, and no low potassium or sodium occurred.
IV. Precautions
We are glad that after a series of medication treatment, the patient’s tinnitus symptoms basically disappeared and the blood pressure control was more stable. However, the patient still needs to pay attention to the following after discharge from the hospital.
1. attention needs to be paid to improving lifestyle in daily life and limiting sodium intake in diet to no more than 6g of salt per day, which can be precisely controlled by a salt control spoon.
2, hydrochlorothiazide as a diuretic, through diuresis to reduce blood volume, in order to play a hypotensive effect, but at the same time, the drug will affect the excretion of uric acid in the body, making uric acid reabsorption increase, blood uric acid rise, and even induce gout, so patients still need to regularly recheck uric acid and electrolytes during the drug after discharge.
3, patients should pay attention to observe their own symptoms during the daily medication, once in the process of lowering blood pressure discomfort symptoms, need to promptly come to the hospital, under the guidance of doctors to complete drug adjustments. At the same time, pay attention to keep a happy mood, pay attention to the monitoring of blood pressure, and adhere to regular and long-term medication.
V. Personal insight
Hypertension is a common disease among middle-aged and elderly people. Patients are mostly asymptomatic in the early stage and therefore difficult to detect, but some patients occasionally have symptoms such as dizziness, headache, blurred vision, tinnitus and insomnia. The patient in this article was seen for sudden onset of tinnitus, so the hypertensive condition could be detected in time and given timely treatment with good therapeutic effect.
Tinnitus caused by hypertension is mainly manifested as intermittent buzzing sounds in the ears that last for a long period of time. In this type of patients, the tinnitus can mostly be relieved after the blood pressure is controlled and stabilized. Low sodium diet and regular blood pressure monitoring in daily life are behaviors that help us to detect and control blood pressure early.