Relationship Between Epistaxis And Hypertension: A Study Of Patients Seen In The Emergency Units Of Two Tertiary Health Institutions In Nigeria

Abstract

Both epistaxis and hypertension are common in the general population.
This study aimed at determining the prevalence of hypertension among epistaxics, and the
relationship between epistaxis and hypertension. Retrospective analysis of 62 adults comprising 31 each of males and females with a mean age of 41.4 ± 16.6 years (range: 18-90 years) that presented in the emergency units of two tertiary health institutions
seen over 11 years was done.Main outcome measure was the prevalence of hypertension amongst epistaxics. Seventy-six age and sex-matched patients with bleeding from sites other than the nostrils with no record of epistaxiswere selected by simple random sampling as controls. Peak prevalence of epistaxis occurred during the months of January and March. Compared to the controls, the epistaxics had significantly higher blood pressures: (146.1 ± 40.7 mmHg versus 123.2 ± 16.3 mmHg systolic, P =0.001), and (91.3 ± 24.8 mmHg versus 78.2 ± 12.8 mmHg diastolic, P=0.001), and higher proportions of patientswith previous history of hypertension (32.3% versus 7.9%; p<0.001) and family history
of hypertension (12.9% versus 2.6%; p<0.02).The proportion of subjects with blood pressure elevation at presentation that remained sustained was significantly higher among the epistaxics than the nonepistaxics (87.5% versus 47.6%, =8.1, P=0.005). The epistaxics had significantly higher prevalence of hypertension than the non-epistaxics (45.2% versus 13.2%, =17.5, p=0.001). Univariate analysis demonstrated association between epistaxis and hypertension (OR=5.4, 95% CI=2.4-12.5, P=0.001), and between epistaxis
and age (OR=0.9, 95% CI=1.3-12.5, P=0.02). On multivariate analysis using logistic regression the association between epistaxis and hypertension persisted, after adjusting for age, sex, season and causes of epistaxis (OR=5.6,95%CI=1.7-15.6, P=0.01).
Our findings support an association between epistaxis and hypertension in the study population.

Keywords:Epistaxis, Hypertension.

Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 379-382