Phantom odor perception and vascular conditions among adults in the United States: National Health and Nutrition Examination Survey 2011-2014.

Objectives/hypothesis: Phantom odor perception has been correlated with burden of vascular risk among older adults. We evaluated associations between vascular conditions and phantom odor perception among adults in the United States.

Study Design: Cross-sectional analysis.

Methods: Cross-sectional data were collected as part of the 2011 to 2014 National Health and Nutrition Examination Survey, yielding a nationally representative sample of 7,417 adults aged 40 years and older. Phantom odor perception was defined as report of an unpleasant, bad, or burning odor when nothing is there. Participants reported on vascular conditions including history of stroke. Total cholesterol and glycated hemoglobinwere measured. High blood pressure was ascertained during an examination.

Results: Stroke was associated with a 76% greater likelihood of phantom odor perception. Congestive heart failure and angina were associated with three times and 2.8 times the odds of phantom odor perception among adults 40 to 59 years and 60 years and older, respectively. Adults with diagnosed, but controlled, high cholesterol reported phantom odors more frequently than those without high cholesterol. Adults with diagnosed, but controlled, high blood pressure reported phantom odors more frequently than those without high blood pressure. We observed a threefold greater odds of phantom odor perception among adults aged 60 years and older with diabetes, but only among those who use both insulin and oral medications.

Conclusions: Stroke, angina, congestive heart failure, well-managed high blood pressure, and well-managed high cholesterol are associated with phantom odor perception. Vascular or metabolic conditions or their treatments may contribute to reporting of phantom odor perception.

Level Of Evidence: NA Laryngoscope, 130:332-337, 2020.