Epistaxis is more common in hypertensive patients, perhaps owing to vascular fragility from long-standing disease.
Hypertension, however, is rarely a direct cause of epistaxis. More commonly, epistaxis and the associated anxiety may cause an acute elevation of blood pressure.
Chsngsun Kim, Sahmyook Medical Center, Republic of Korea, and colleagues aimed to investigate whether high blood pressure and hypertension are associated with epistaxis.
The researchers performed a retrospective study with a propensity score matching analysis at the emergency departments (EDs) of a tertiary university hospital.
The mean blood pressure (BP, systolic and diastolic) and proportion of subjects with elevated BP (systolic >120 and/or diastolic >80 mmHg) at presentation were compared between the epistaxis group and matched control group. Also, the proportion of patients with newly diagnosed hypertension within six months between the two groups was compared.
The researchers matched a total of 1353 patients with epistaxis and the same number of those with simple lacerations.
Key findings of the study include:
- The mean systolic and diastolic BPs of the epistaxis group were significantly higher than those of the matched control group (157.1 ± 26.4 and 91.4 ± 17.0 mmHg versus 144.9 ± 32.4 and 84.2 ± 13.5 mmHg).
- The proportion of patients with elevated BP at presentation was also significantly higher in the epistaxis group (91.4%) than in the matched control group (86.2%).
- Of the 724 (53.5%) patients without pre-existing hypertension in the epistaxis group, 660 patients were followed, of whom 107 (16.2%) were newly diagnosed with hypertension within 6 months, which was a significantly higher percentage than among the matched controls (4.9%).
"The patients with epistaxis had elevated BP at presentation and a higher proportion of newly diagnosed hypertension within six months compared to the matched controls," concluded the authors.
The study, "Is epistaxis associated with high blood pressure and hypertension? Propensity score matching study," is published in the American Journal of Emergency Medicine.
DOI: https://doi.org/10.1016/j.ajem.2019.10.025
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