Hostname: page-component-76fb5796d-qxdb6 Total loading time: 0 Render date: 2024-04-27T02:19:58.279Z Has data issue: false hasContentIssue false
  • English
  • Français

The significance of atherosclerosis in hypertensive patients with epistaxis

Published online by Cambridge University Press:  15 February 2018

S Elwany ,
A A Ibrahim ,
A I Soliman ,
R Bazak  and
H A Ibrahim
S Elwany*
Affiliation:
Department of Otolaryngology, Alexandria Faculty of Medicine, Egypt
A A Ibrahim
Affiliation:
Department of Otolaryngology, Alexandria Faculty of Medicine, Egypt
A I Soliman
Affiliation:
Department of Otolaryngology, Alexandria Faculty of Medicine, Egypt
R Bazak
Affiliation:
Department of Otolaryngology, Alexandria Faculty of Medicine, Egypt
H A Ibrahim
Affiliation:
Department of Ophthalmology, Alexandria Faculty of Medicine, Egypt
*
Address for correspondence: Dr Samy Elwany, Department of Otolaryngology, Alexandria Faculty of Medicine, Alexandria, Egypt E-mail: samyelwany@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

The relationship between hypertension and epistaxis is controversial and poorly understood. The present research investigated atherosclerosis as a potential risk factor in hypertensive patients with epistaxis.

Methods:

A prospective study of 141 hypertensive patients with epistaxis was conducted. The laboratory tests included full blood count, lipid profile and coagulation profile. All patients underwent funduscopic examination of the eye and were classified in terms of four retinopathy grades.

Results:

There were strong positive correlations between the number of nosebleeds and retinopathy grade and low-density lipoprotein cholesterol level. There were weak correlations between the number of nosebleeds and blood pressure readings and triglycerides levels. Patients with grade III retinopathy, suggesting atherosclerosis, suffered from more frequent nosebleeds than other patients.

Conclusion:

Atherosclerosis is one of the potential risk factors in hypertensive patients with epistaxis. This may have an impact on treatment choices.

Keywords

HypertensionEpistaxisRetinaAtherosclerosisCholesterol
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 132 , Issue 4 , April 2018 , pp. 323 - 326
Copyright
Copyright © JLO (1984) Limited 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Goddard, GC, Reiter, ER. Inpatient management of epistaxis: outcomes and cost. Otolaryngol Head Neck Surg 2005;152:707–12.CrossRefGoogle Scholar
2Comelli, I, Vincenti, V, Benatti, M, Macri, GF, Comelli, D, Lippi, G et al. Influence of air temperature variations on incidence of epistaxis. Am J Rhinol Allergy 2015;29:175–81.CrossRefGoogle ScholarPubMed
3Isezuo, SA, Segun-Busari, S, Ezunu, E, Yakubu, A, Iseh, K, Legbo, J et al. Relationship between epistaxis and hypertension: a study of patients seen in the emergency units of two tertiary health institutions in Nigeria. Niger J Clin Pract 2008;11:379–82.Google ScholarPubMed
4Olatoke, F, Ologe, FE, Alabi, BS, Dunmade, AD, Busari, SS, Afolabi, OA. Epistaxis. A five-year review. Saudi Med J 2006;27:1077–9.Google ScholarPubMed
5Dal Secchi, MM, Indolfo, ML, Rabesquine, MM, de Castro, FB. Epistaxis: prevailing factors and treatment. Int Arch Otorhinolaryngol 2009;3:381–5.Google Scholar
6Kikidis, T, Tsioufis, K, Papanikolaou, V, Zerva, K, Hantzakos, A. Is epistaxis associated with arterial hypertension? A systematic review of the literature. Eur Arch Otorhinolaryngol 2014;271:237–43.CrossRefGoogle ScholarPubMed
7Ibrashi, F, Sabri, N, Eldawi, M, Belal, A. Effect of atherosclerosis and hypertension on arterial epistaxis. J Laryngol Otol 1978;928:77–81.Google Scholar
8Herkner, H, Havel, C, Müllner, M, Gamper, G, Bur, A, Temmel, AF et al. Active epistaxis at ED presentation is associated with arterial hypertension. Am J Emerg Med 2002;20:92–4.CrossRefGoogle ScholarPubMed
9Wang, L, Wong, TY, Sharrett, AR, Klein, R, Folsom, AR, Jerosch-Herold, M. Relationship between retinal arteriolar narrowing and myocardial perfusion. Hypertension 2008;51:119–26.CrossRefGoogle ScholarPubMed
10Lubianca Neto, JF, Fuchs, FD, Facco, SR, Gus, M, Fasolo, L, Mafessoni, R. Is epistaxis evidence of end-organ damage in patients with hypertension? Laryngoscope 1999;109:111–15.Google ScholarPubMed
11Charan, J, Biswas, T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med 2013;35:121–6.CrossRefGoogle ScholarPubMed
12Keith, NM, Wagener, HP, Barker, NW. Some different types of essential hypertension: their course and prognosis. Am J Med Sci 1974;268:336–45.CrossRefGoogle ScholarPubMed
13Knopfholz, J, Lima-Junior, E, Précoma-Neto, D, Faria-Neto, JR. Association between epistaxis and hypertension: a one year follow-up after an index episode of nose bleeding in hypertensive patients. Int J Cardiol 2009;134:107–9.CrossRefGoogle ScholarPubMed
14Fuchs, FD, Moreira, LB, Pires, CP, Torres, FS, Furtado, MV, Moraes, RS et al. Absence of association between hypertension and epistaxis: a population-based study. Blood Press 2003;12:145–8.CrossRefGoogle ScholarPubMed
15Karras, DJ, Ufberg, JW, Harrigan, RA, Wald, DA, Botros, MS, McNamara, RM. Lack of relationship between hypertension-associated symptoms and blood pressure in hypertensive ED patients. Am J Emerg Med 2005;23:106–10.CrossRefGoogle ScholarPubMed
16Viducich, RA, Blanda, MP, Gerson, LW. Posterior epistaxis: clinical features and acute complications. Ann Emerg Med 1995;25:592–6.CrossRefGoogle ScholarPubMed
17Herkner, H, Laggner, AN, Müllner, M, Formanek, M, Bur, A, Gamper, G et al. Hypertension in patients presenting with epistaxis. Ann Emerg Med 2000;35:126–30.CrossRefGoogle ScholarPubMed
18Pollice, P, Yoder, M. A retrospective review of hospitalized patients. Otolaryngol Head Neck Surg 1997;117:49–53.CrossRefGoogle ScholarPubMed
19Gunn, RM. On ophthalmoscopic evidence of general arterial disease. Trans Ophthalmol Soc UK 1898;18:356–81.Google Scholar
20Wong, TY, Mitchell, P. Hypertensive retinopathy. N Engl J Med 2004;351:2310–17.CrossRefGoogle ScholarPubMed
21Klein, R, Klein, BE, Moss, SE. The relation of systemic hypertension to changes in the retinal vasculature. The Beaver Dam Eye Study. Trans Am Ophthalmol Soc 1997;95:329–50.Google ScholarPubMed
22Wang, JJ, Mitchell, P, Leung, H, Rochtchina, E, Wong, TY, Klein, R. Hypertensive retinal vessel wall signs in the general older population: the Blue Mountains Eye Study. Hypertension 2003;42:534–41.CrossRefGoogle ScholarPubMed
23Klein, R, Sharrett, AR, Klein, BE, Chambless, LE, Cooper, LS, Hubbard, LD et al. The association of atherosclerosis, vascular risk factors, and retinopathy in adults with diabetes: the atherosclerosis risk in communities study. Ophthalmology 2002;109:1225–34.CrossRefGoogle ScholarPubMed
24Ikram, MK, de Jong, FJ, Vingerling, JR, Witteman, JC, Hofman, A, Breteler, MM et al. Are retinal arteriolar or venular diameters associated with markers for cardiovascular disorders? The Rotterdam Study. Invest Ophthalmol Vis Sci 2004;45:2129–34.CrossRefGoogle ScholarPubMed