Epistaxis and Clinic Blood Pressure Values: Is There a Relationship?

High Blood Press Cardiovasc Prev. 2024 Sep;31(5):493-500. doi: 10.1007/s40292-024-00669-7. Epub 2024 Sep 18.

Abstract

Introduction: 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.

Aim: 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.

Materials and methods: 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.

Results: 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.

Conclusion: 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.

Keywords: Blood pressure; Emergencies; Epistaxis; Hypertension.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure Determination
  • Blood Pressure* / drug effects
  • Chi-Square Distribution
  • Emergency Service, Hospital*
  • Epistaxis* / epidemiology
  • Epistaxis* / physiopathology
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Hypertension* / physiopathology
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / adverse effects
  • Platelet Aggregation Inhibitors / therapeutic use
  • Retrospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Platelet Aggregation Inhibitors
  • Antihypertensive Agents
  • Anticoagulants