Related Experiment Video
Updated: May 21, 2026

Integrated Compensatory Responses in a Human Model of Hemorrhage
Published on: November 20, 2016
Relationship between blood pressure and persistent epistaxis at the emergency department: a retrospective study
Moriyuki Terakura1, Ryuichi Fujisaki, Takaoki Suda
1Department of Emergency Medicine, Teikyo University School of Medicine, Tokyo, Japan. m-teraku@mb3.suisui.ne.jp
Background:
Persistent nosebleed episodes have occurred in patients with idiopathic epistaxis from Kiesselbach's area despite confirmed location of the bleeding site, but the cause remains unclear. We tried to determine whether persistent epistaxis was associated with blood pressure.
Methods And Results:
Between May 2009 and May 2010, the records for 133 adult patients with idiopathic epistaxis from Kiesselbach's area were obtained from the emergency department of our hospital. The bleeding site was pressed with a cotton strip for about 30 minutes, followed by checking for nosebleed. Comparison of background factors by the presence or absence of persistent epistaxis revealed a significantly higher systolic blood pressure in patients with persistent nosebleed than in those without (181.3 ± 26.9 vs. 156.6 ± 26.1 mm Hg; P < .0001). Persistent epistaxis was significantly more frequent in patients with hypertension than in those without (26% vs. 8%; P = .002). Multivariate logistic analysis revealed systolic blood pressure to be an independent factor associated with epistaxis persistence (odds ratio, 1.03; 95% confidence interval, 1.01-1.06; P = .002).
Conclusion:
Proper blood pressure management is necessary for the prevention of persistent epistaxis from Kiesselbach's area in the clinical setting of emergency care practice.
Related Concept Videos
Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Measurement of Blood Pressure
Assessment of blood pressure in brachial artery(two-step method)
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Pre-Procedural Guidelines for Assessing Blood Pressure
Errors occurring during blood pressure monitoring
Several factors...
