title: A possible cause of epistaxis: increased masked hypertension prevalence in patients with epistaxis.
abstract: BACKGROUND
  Epistaxis and hypertension are frequent conditions in the adult population. Masked hypertension is defined as a clinical condition in which a patient's office blood pressure level is <140/90mmHg, but the ambulatory or home blood pressure readings are in the hypertensive range. Many studies have proved that hypertension is one of the most important causes of epistaxis. The prevalence of this condition in patients with epistaxis is not well defined.
  
  
  OBJECTIVE
  This study aimed to evaluate the prevalence of masked hypertension using the results of office blood pressure measurement compared with the results of ambulatory blood pressure monitoring.
  
  
  METHODS
  Sixty patients with epistaxis and 60 control subjects were enrolled in the study. All patients with epistaxis and controls without history of hypertension underwent physical examination, including office blood pressure measurement, ambulatory or home blood pressure, and measurement of anthropometric parameters.
  
  
  RESULTS
  Mean age was similar between the epistaxis group and the controls - 21-68 years (mean 42.9) for the epistaxis group and 18-71 years (mean 42.2) for the control group. A total of 20 patients (33.3%) in the epistaxis group and 7 patients (11.7%) in the control group (p=0.004) had masked hypertension. Night-time systolic blood pressure was significantly higher in patients with epistaxis than in the control group (p<0.005). However, no significant difference was found in daytime systolic blood pressure between the control group and the patients with epistaxis (p=0.517).
  
  
  CONCLUSIONS
  This study demonstrates increased masked hypertension prevalence in patients with epistaxis. We suggest that all patients with epistaxis should undergo ambulatory or home blood pressure to detect masked hypertension, which could be a possible cause of epistaxis.
authors.affiliation: Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey. Electronic address: drbaranacar@gmail.com.
authors.forename: Baran
authors.initials: B
authors.lastname: Acar
authors.affiliation: Medical Park Ankara Hospital, Department of Cardiology, Yenimahalle, Turkey.
authors.forename: Bunyamin
authors.initials: B
authors.lastname: Yavuz
authors.affiliation: Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Yıldız
authors.affiliation: Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Ozkan
authors.affiliation: Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ayturk
authors.affiliation: Kecioren Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Sen
authors.affiliation: Kecioren Training and Research Hospital, Department of Otorhinolaryngology, Ankara, Turkey.
authors.forename: Onur Sinan
authors.initials: OS
authors.lastname: Deveci
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018660:Blood Pressure Monitoring, Ambulatory; D016022:Case-Control Studies; D004844:Epistaxis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D059468:Masked Hypertension / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
keywords: Epistaxe; Epistaxis; Espontânea; Hipertensão mascarada; Masked hypertension; Spontaneous