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Hypertension in patients presenting with epistaxis
H Herkner1, A N Laggner, M Müllner
1Departments of Emergency Medicine and Otorhinolaryngology, University of Vienna Medical School, Vienna, Austria.
Annals of Emergency Medicine
|January 29, 2000
Summary
Patients experiencing nosebleeds (epistaxis) have higher blood pressure than other emergency patients. A significant majority of those with elevated blood pressure during epistaxis have sustained hypertension, often undiagnosed.
Area of Science:
- Cardiology
- Emergency Medicine
- Hypertension Research
Background:
- Epistaxis is a common emergency department presentation.
- Elevated blood pressure is frequently observed during epistaxis episodes.
- The link between epistaxis-related hypertension and sustained arterial hypertension requires further investigation.
Purpose of the Study:
- To compare arterial blood pressure in emergency department patients with epistaxis versus those with other medical emergencies.
- To determine the association between elevated blood pressure during epistaxis and sustained arterial hypertension.
- To assess the prevalence of undiagnosed hypertension in epistaxis patients.
Main Methods:
- Prospective, cross-sectional prevalence study design.
- Comparison of arterial blood pressure on admission between 213 epistaxis patients and 213 matched controls.
- Utilized 24-hour ambulatory blood pressure monitoring to diagnose sustained arterial hypertension in a subset of patients.
Main Results:
- Patients with epistaxis exhibited significantly higher systolic (161+/-30 vs 144+/-22 mm Hg) and diastolic (84+/-19 vs 75+/-15 mm Hg) blood pressure compared to controls.
- Sustained arterial hypertension was diagnosed in 79% (26 of 33) of epistaxis patients with elevated blood pressure.
- 27% (9 of 33) of patients with sustained hypertension were unaware of their condition, and these patients reported more frequent epistaxis episodes.
Conclusions:
- Epistaxis patients present with higher arterial blood pressure than control groups.
- A high prevalence of sustained arterial hypertension exists among epistaxis patients with elevated blood pressure.
- Routine 24-hour ambulatory blood pressure monitoring is recommended for epistaxis patients with elevated blood pressure to identify and manage sustained hypertension, including previously undiagnosed cases.