Epistaxis and Clinic Blood Pressure Values: Is There a Relationship?
Blood pressure
Emergencies
Epistaxis
Hypertension
Journal
High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension
ISSN: 1179-1985
Titre abrégé: High Blood Press Cardiovasc Prev
Pays: New Zealand
ID NLM: 9421087
Informations de publication
Date de publication:
18 Sep 2024
18 Sep 2024
Historique:
received:
15
07
2024
accepted:
02
09
2024
medline:
18
9
2024
pubmed:
18
9
2024
entrez:
17
9
2024
Statut:
aheadofprint
Résumé
Epistaxis is the most common otorhinolaryngological emergency and historically there have been an important debate whether there is a cause-effect relationship with high blood pressure. This retrospective study explored whether hypertension is a significant risk factor for epistaxis in Emergency Department (ED) patients and examined associations between blood pressure levels and epistaxis episodes. Two groups were studied: Group A (patients with epistaxis) and Group B (control). Patient characteristics, comorbidities, and medication use were recorded. Blood pressure measurements were taken upon ED arrival and after specialist evaluation. Statistical analyses included descriptive statistics, T-test, χ2 test, and logistic regression. Group A, enrolled from April 2014 to February 2015, included 102 patients, mean age 67, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 73%, decreasing to 26% after 30 minutes. Group B, enrolled from May 2023 to August 2023, included 126 patients, mean age 59, male-female ratio 2:1. Blood pressure on arrival was over 140/90 mmHg in 60%, decreasing to 23% after 30 minutes. Both groups showed reduced blood pressure post-evaluation. Logistic regression identified anticoagulant and/or antiplatelet therapy as the main independent risk factor for epistaxis. Age, sex, blood pressure levels, and hypertension did not significantly influence epistaxis occurrence. No significant correlation between hypertension and epistaxis was found. Anticoagulant and/or antiplatelet therapy was the primary independent risk factor, highlighting the importance of considering medication history in evaluating epistaxis.
Identifiants
pubmed: 39289332
doi: 10.1007/s40292-024-00669-7
pii: 10.1007/s40292-024-00669-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s).
Références
Morgan DJ, Kellerman R. Epistaxis: evaluation and treatment. Prim Care. 2014;41(1):63–73. https://doi.org/10.1016/j.pop.2013.10.007 .
doi: 10.1016/j.pop.2013.10.007
pubmed: 24439881
Brown NJ, Berkowitz RG. Epistaxis in Healthy Children Requiring Hospital Admission. Int J Pediatr Otorhinolaryngol. 2004;68(9):1181–4. https://doi.org/10.1016/j.ijporl.2004.04.015 .
doi: 10.1016/j.ijporl.2004.04.015
pubmed: 15302149
Walker TW, Macfarlane TV, McGarry GW. 2007. The Epidemiology and Chronobiology of Epistaxis: An Investigation of Scottish Hospital Admissions 1995–2004. Clin Otolaryngol 32, no. 5 (Oct): 361-5. https://doi.org/10.1111/j.1749-4486.2007.01530.x
Rosenblut A, Bardin PG, Muller B, Faris MA, Wu WW, Caldwell MF, Fokkens WJ. Long-term safety of Fluticasone Furoate Nasal Spray in adults and adolescents with perennial allergic Rhinitis. Allergy. 2007;62(9):1071–7. https://doi.org/10.1111/j.1398-9995.2007.01521.x .
doi: 10.1111/j.1398-9995.2007.01521.x
pubmed: 17686110
Ando Y, Iimura J, Arai S, Arai C, Komori M, Tsuyumu M, Hama T, Shigeta Y, Hatano A, Moriyama H. Risk factors for recurrent Epistaxis: importance of initial treatment. Auris Nasus Larynx. 2014;41(1):41–5. https://doi.org/10.1016/j.anl.2013.05.004 .
doi: 10.1016/j.anl.2013.05.004
pubmed: 23791424
Petruson B, Rudin R, Svärdsudd K. Is high blood pressure an aetiological factor in Epistaxis? ORL J Otorhinolaryngol Relat Spec. 1977;39(3):155–60. https://doi.org/10.1159/000275350 .
doi: 10.1159/000275350
pubmed: 339142
Fuchs FD, Moreira LB, Pires CP, Torres FS, Furtado MV, Moraes RS, Wiehe M, Fuchs SC. and J. F. Lubianca Neto. 2003. Absence of Association between Hypertension and Epistaxis: A Population-Based Study. Blood Press 12, no. 3: 145-8. https://doi.org/10.1080/08037050310001750
Herkner H, Havel C, Müllner M, Gamper G, Bur A, Temmel AF, Laggner AN, Hirschl MM. Active Epistaxis at Ed Presentation is Associated with arterial hypertension. Am J Emerg Med. 2002;20(2):92–5. https://doi.org/10.1053/ajem.2002.31577 .
doi: 10.1053/ajem.2002.31577
pubmed: 11880870
Isezuo SA, Segun-Busari S, Ezunu E, Yakubu A, Iseh K, Legbo J, Alabi BS, Dunmade AE, Ologe FE. Relationship between Epistaxis and Hypertension: a study of patients seen in the Emergency Units of Two Tertiary Health Institutions in Nigeria. Niger J Clin Pract. 2008;11(4):379–82.
pubmed: 19320416
André N, Klopp-Dutote N, Biet-Hornstein A, Strunski V, Page C. Cardiovascular Risk and Severity factors in patients admitted to hospital for spontaneous Epistaxis. Eur Ann Otorhinolaryngol Head Neck Dis. 2018;135(2):119–22. https://doi.org/10.1016/j.anorl.2017.11.004 .
doi: 10.1016/j.anorl.2017.11.004
pubmed: 29229197
Lubianca Neto JF, Fuchs FD, Facco SR, Gus M, Fasolo L, Mafessoni R, Gleissner AL. 1999. Is Epistaxis evidence of end-organ damage in patients with hypertension? Laryngoscope 109, 7 pt 1 (Jul): 1111–5. https://doi.org/10.1097/00005537-199907000-00019
Lubianca-Neto JF, Bredemeier M, Carvalhal EF, Arruda CA, Estrella E, Pletsch A, Gus M, Lu L, Fuchs FD. A study of the Association between Epistaxis and the severity of hypertension. Am J Rhinol. 1998;12(4):269–72. https://doi.org/10.2500/105065898781389985 .
doi: 10.2500/105065898781389985
pubmed: 9740920
Acar B, Yavuz B, Yıldız E, Ozkan S, Ayturk M, Sen O, Deveci OS. A possible cause of Epistaxis: increased masked hypertension prevalence in patients with Epistaxis. Braz J Otorhinolaryngol. 2017;83(1):45–9. https://doi.org/10.1016/j.bjorl.2016.01.007 .
doi: 10.1016/j.bjorl.2016.01.007
pubmed: 27133905
Page C, Biet A, Liabeuf S, Strunski V, Fournier A. Serious spontaneous Epistaxis and Hypertension in Hospitalized patients. Eur Arch Otorhinolaryngol. 2011;268(12):1749–53. https://doi.org/10.1007/s00405-011-1659-y .
doi: 10.1007/s00405-011-1659-y
pubmed: 21656167
Michel J, Prulière Escabasse V, Bequignon E, Vérillaud B, Robard L, Crampette L, Malard O, Work-Group SFORL. Epistaxis and High Blood Pressure. Eur Ann Otorhinolaryngol Head Neck Dis. 2017;134(1):33–5. https://doi.org/10.1016/j.anorl.2016.09.011 . Guidelines of the French Society of Otorhinolaryngology (Sforl).
Byun H, Chung JH, Lee SH, Ryu J, Kim C, Shin JH. Association of Hypertension with the risk and severity of Epistaxis. JAMA Otolaryngol Head Neck Surg. 2020;147(1):1–7. https://doi.org/10.1001/jamaoto.2020.2906 .
doi: 10.1001/jamaoto.2020.2906
pubmed: 32910190
pmcid: 7489409
Kikidis D, Tsioufis K, Papanikolaou V, Zerva K, Hantzakos A. Is Epistaxis Associated with arterial hypertension? A systematic review of the literature. Eur Arch Otorhinolaryngol. 2014;271(2):237–43. https://doi.org/10.1007/s00405-013-2450-z .
doi: 10.1007/s00405-013-2450-z
pubmed: 23539411
Min HJ, Kang H, Choi GJ, Kim KS. Association between Hypertension and Epistaxis: systematic review and Meta-analysis. Otolaryngol Head Neck Surg. 2017;157(6):921–7. https://doi.org/10.1177/0194599817721445 .
doi: 10.1177/0194599817721445
pubmed: 28742425
Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F, Task Force Members. 2013 Esh/Esc guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (Esh) and of the European Society of Cardiology (Esc). J Hypertens. 2013;31(7):1281–357. https://doi.org/10.1097/01.hjh.0000431740.32696.cc .
doi: 10.1097/01.hjh.0000431740.32696.cc
pubmed: 23817082