ASSOCIATION OF EPISTAXIS WITH HYPERTENSION IN A TERTIARY CARE HOSPITAL

Abstract

Objective
To find out the association between hypertension and spontaneous epistaxis in adult patients presenting to an emergency department of a military hospital in Pakistan.

Study Design

A hospital based Case–control study

Place and Duration of Study

Emergency Department of Pak Emirates Military Hospital, Rawalpindi, from February 2022 to February 2023.

Methodology
A total of 332 participants were enrolled, comprising 166 consecutive cases aged ≥35 years presenting with spontaneous epistaxis and 166 controls without epistaxis. Data collected included demographics, comorbidities, medication use, smoking status, and laboratory indices. Blood pressure was measured using standardized protocols. The severity of epistaxis was defined by management strategy, and statistical analysis included chi-square and t-tests for initial comparisons, followed by logistic regression to control for confounding.

Results
The mean age was 54.7 ± 12.4 years, with no significant difference in gender distribution between cases and controls. Cases were slightly older than controls (56.4 ± 11.3 vs. 53.1 ± 13.2 years, p = 0.015). Hypertension was significantly more frequent among cases 121 (61.7%) than controls 75 (38.3%) (p < 0.001). After adjustment, hypertension remained strongly associated with epistaxis (aOR 3.83, 95% CI 2.30–6.30). Antiplatelet use (aOR 2.07, 95% CI 1.20–3.50) and older age (aOR 1.03, 95% CI 1.01–1.10) were also independent predictors, while anticoagulant use and platelet count showed borderline associations.

Conclusion
Hypertension is independently associated with spontaneous epistaxis and contributes to more severe presentations.