The sound profile of a blower card is highly dependent on the build quality of the cooler. The 5700XT was pretty much a worst case scenario. However the GTX 1080 had an excellent sound profile under load and was tested to be actually quieter than axial 3rd party fans by both Bitwit and LTT.
In my own personal experience, I’ve seen some pretty nasty feedback loops even with bottom facing exhaust fans. I upgraded my NCASE M1 build from a 6700K to a 8086K. In the process I switched from air cooling to a 240mm AIO. Everything was fine until I upgraded the GPU from a 980ti blower to a 2080 FE. The 2080FE dumped so much heat into the case that the 8086K would throttle as well as the GPU. Downward facing exhaust fans helped slightly, but ultimately couldn’t sustain the system past about 30 minutes of gaming.
Ultimately, I moved to a better ventilated case.
I’m trying to gather some older high-power GPUs with blowers vs coolers for a test, but finances are tight right now. In the future though, I hope to do so.