AB394         NOSEBLEED AND HYPERTENSION IN PRIMARY CARE

Author(s): 
Voulioti S, Giannopoulos D, Karokis D, Michalis D, Halvatzis S, Kermanidou E, Batikas A , Koumarelas V
Health Centre of Kalloni, MYTILINI - LESBOS, GREECE
Text: 
Objective:
To determine, in people presenting with nosebleed to General Practitioners, if increased blood pressure (BP) is the cause or a result of the nosebleed.
Material-method:
246 individuals, 140 males-106 females, aged between 37-76 years, mean age 69,2 years, presented with nosebleed to our Health Centres (emergency departments) between March 1998 and March 1999. Blood pressure was measured twice for each patient (once at the time of presentation and once a week later). All measurements were done with manometers of the same type. Patients were characterized as hypertensive, if their BP was >130/85 mmHg for ages £65 years and >140/90 mm Hg for ages >65 years. Patients were classified in three groups: a) Patients with nosebleed, normotensives, b) Patients with nosebleed, hypertensives, with (known) well controlled hypertension, c) Patients with nosebleed, hypertensives, with (known) uncontrolled hypertension. Statistical analysis was done using the x2 test.
Results: Group (a) included 134 patients (54,47%), 74 males and 60 females. For 74 pts (55,25%), it was the 1st episode of nosebleed, for 48 pts (35,82) it was the 2nd or 3rd episode, and for 12 pts (8,95%) it was >3rd episode. Group (b) included 40 pts (16,26%), 28 males and 12 females. For 22 pts (55%) it was the 1st episode, for 14 pts (35%) it was the 2nd3rd episode, and for 8 pts (11,11%) it was >3rd episode Group (c) included 72 pts (29,27%), 38 males and 34 females. For 38pts (52,8%) it was the 1st episode, for 26 pts it was the 2nd-3rd episode, and for 8 pts (11,11%) it was >3rd episode. There were no statistically significant differences between the groups regarding the number of episodes of nosebleed, no matter whether their BP was normal or they had controlled or no hypertension.
Conclusion:
The distribution of males and females as well as the number of episodes of nosebleed was similar in all categories. Therefore it seems that the increased BP, which is frequently found during such episodes, might well be the result of the nosebleed (i.e. stress-related) and not the cause. General Practitioners must be very careful and avoid characterizing patients with nosebleed as ‘Hypertensives’ based only on an increased BP during the incident.