Risk factors for hospitalized upper or lower gastrointestinal tract bleeding in treated hypertensives.
BACKGROUND
We examined risk factors for hospitalized gastrointestinal bleeding among health maintenance organization (HMO) members with hypertension.


METHODS
Case subjects (n = 199) were patients with hypertension hospitalized for confirmed gastrointestinal bleeding in 1992-1994. Control hypertensive subjects (n = 821) were selected from ongoing studies. Medical records and computerized pharmacy data were used to assess risk factors. Adjusted relative risks (RRs) were estimated using logistic regression models.


RESULTS
In multivariate-adjusted models, significant risk factors for upper gastrointestinal bleeding (n = 111 cases) were hepatic disease (RR = 2.85), elevated creatinine (RR = 2.45), nonsteroidal anti-inflammatory drug use (RR = 2.28), smoking (RR = 1.93), cardiovascular disease (RR = 1.89), and physical inactivity (RR = 1.70). Risk factors for lower gastrointestinal bleeding (n = 43 cases) in multivariate-adjusted analyses were anticoagulant or thrombolytic therapy (RR = 3.80), elevated creatinine (RR = 2.31), and physical inactivity (RR = 2.10).


CONCLUSIONS
This study confirmed several known risk factors for hospitalized gastrointestinal bleeding, including hepatic disease, renal dysfunction, and medication use, and also identified smoking and physical inactivity as independent risk factors. The magnitude of the relative risks associated with these behavioral factors suggests that lifestyle modification may substantially reduce the risk of gastrointestinal bleeding.
Kaplan
Robert C
RC
Cardiovascular Health Research Unit, University of Washington, USA. rkaplan@aecom.yu.edu
Heckbert
Susan R
SR
Psaty
Bruce M
BM
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D000925:Anticoagulants / Q000009:adverse effects; D016022:Case-Control Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012306:Risk; D014861:Washington / Q000453:epidemiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D005343:Fibrinolytic Agents