Association between Hypertension and Epistaxis: Systematic Review and Meta-analysis

Area of Science:

• Cardiology
• Otorhinolaryngology

Background:

• The relationship between epistaxis (nosebleeds) and hypertension has been debated for years.
• Understanding this association is crucial for clinical management and risk assessment.

Purpose of the Study:

• To systematically review and meta-analyze existing studies to determine the association between epistaxis and hypertension.
• To investigate if hypertension is an independent risk factor for epistaxis.

Main Methods:

• A comprehensive literature search was conducted across MEDLINE, EMBASE, and Cochrane Library.
• Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed.
• Ten studies were selected from 2768 unique studies for the meta-analysis.

Main Results:

• Patients with hypertension showed a significantly increased risk of epistaxis (odds ratio, 1.532; 95% CI, 1.181-1.986).
• The number needed to treat was 14.9 (95% CI, 12.3-19.0), indicating the number of hypertensive patients needed to observe one additional case of epistaxis.
• Considerable heterogeneity was noted (I² = 49.3%), with sensitivity analyses confirming the robustness of the findings.

Conclusions:

• Hypertension is significantly associated with an increased risk of epistaxis.
• The current evidence does not establish a causal relationship.
• Further large-scale clinical trials are necessary to elucidate the impact of hypertension on epistaxis.