Is Epistaxis Evidence of End-Organ Damage in Patients With Hypertension?

Objectives/Hypothesis: To study the association between history of mild to severe epistaxis with different stages of hypertension and with other evidence of target organ damage in a sample of patients attending an outpatient hypertension clinic, controlling for potential confounding factors. Study D...

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Bibliographic Details
Published in:	The Laryngoscope Vol. 109; no. 7; pp. 1111 - 1115
Main Authors:	Neto, José Faibes Lubianca, Fuchs, Flávio Danni, Facco, Sandro Rogério, Gus, Miguel, Fasolo, Leonardo, Mafessoni, Rafael, Gleissner, Ana Luiza
Format:	Journal Article Conference Proceeding
Language:	English
Published:	Hoboken, NJ John Wiley & Sons, Inc 01-07-1999 Wiley-Blackwell
Subjects:	Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels blood pressure Blood Vessels - pathology Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Cross-Sectional Studies end epistaxis Epistaxis - etiology Epistaxis - pathology Female Humans Hypertension Hypertension - complications Hypertrophy, Left Ventricular - complications Male Medical sciences Middle Aged Nasal Mucosa - blood supply Nasal Septum - blood supply Nasal Septum - pathology Non tumoral diseases organ damage Otorhinolaryngology. Stomatology Prospective Studies Turbinates - pathology Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology Human Hypertension Epistaxis Nose disease Survey Cardiovascular disease ENT disease Complication Severe Hemorrhage
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Summary:	Objectives/Hypothesis: To study the association between history of mild to severe epistaxis with different stages of hypertension and with other evidence of target organ damage in a sample of patients attending an outpatient hypertension clinic, controlling for potential confounding factors. Study Design: A survey of adult patients with hypertension. Methods: A consecutive sample of 323 adults with hypertension was studied. The main outcome measures were history of adult epistaxis, high blood pressure, duration of hypertension, nasal abnormalities, and fundoscopic and electrocardiogram abnormalities. Results: Ninety‐four patients (29.1% of the whole sample) reported at least one episode of nosebleed after 18 years of age. Of these, 59 (62.8%) needed medical assistance to control at least one of the episodes. The history of epistaxis was not associated with blood pressure classified according to the World Health Organization/International Society of Hypertension paradigm or classified as severe or not severe. There was a trend of an association between history of epistaxis and duration of hypertension. The history of severe epistaxis (epistaxis that needed medical assistance) was not associated with blood pressure classified as severe or not severe and with duration of hypertension. More patients with left ventricular hypertrophy had a positive history of adult epistaxis. There was no association between history of epistaxis or history of severe epistaxis and fundoscopic abnormalities. Among the abnormalities detected at rhinoscopy, only the presence of enlarged septal vessels was associated with history of epistaxis. The presence of enlarged septal vessels was strongly and independently associated with history of epistaxis in the logistic regression model. Duration of hypertension and left ventricular hypertrophy showed a trend for an association with the history of epistaxis in the adult life. Conclusions: A definite association between blood pressure and history of adult epistaxis in hypertensive patients was not found. The evidence for an association of duration of hypertension and left ventricular hypertrophy with epistaxis suggests that epistaxis might be a consequence of long‐lasting hypertension. The association between the presence of enlarged vessels at rhinoscopy with history of epistaxis in hypertensive patients is a novel observation that needs to be addressed in future observations.
Bibliography:	Presented as "Best Rhinology Paper" at the 34th Brazilian Congress of Otorhinolaryngology, Porto Alegre, Brazil, November 1998 ArticleID:LARY5541090719 istex:F9761B733ADD955BA33DAF6FC94046364D5E8C5A ark:/67375/WNG-JCP35163-4 Dr. José Faibes Lubianca Neto was sponsored by a scholarship from CAPES, Brasília, Brazil Presented as “Best Rhinology Paper” at the 34th Brazilian Congress of Otorhinolaryngology, Porto Alegre, Brazil, November 1998 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0023-852X 1531-4995
DOI:	10.1097/00005537-199907000-00019