Does severe high blood pressure with only epistaxis require immediate blood pressure control in the emergency department?

Abstract

Objective:

This study aimed to assess whether pharmacological treatment of patients with severe high blood pressure (BP) with epistaxis in the emergency department (ED) contributes to the reduction in the incidence of epistaxis recurrence.

Methods:

A retrospective chart review over a 5-year period from January 2014 to December 2018 was performed at the ED of a tertiary university hospital. Of the adult patients (≥18) with spontaneous epistaxis, those with severe high BP (systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg) were included in this study. The study participants were divided into two groups: controlled group, patients who received pharmacological antihypertensive treatment in the ED and the non-controlled group. The incidence of epistaxis recurrence was compared between the two groups.

Results:

A total of 294 patients were enrolled. Of these, 100 patients were treated with antihypertensive agents in the ED (controlled group), and the remaining 194 were discharged without pharmacological antihypertensive treatment (non-controlled group). Twelve (12.0%) of 100 patients from the controlled group experienced recurrent epistaxis, while 25 (12.9%) from the non-controlled group experienced recurrence; these recurrence rates were not significantly different (p=0.828).

Conclusions:

Immediate medical treatment of severe high BP in ED patients with epistaxis did not contribute to the reduction of the incidence of epistaxis recurrence.