{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T16:22:08Z","timestamp":1788193328367,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T00:00:00Z","timestamp":1500940800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Whether there is an association or a cause\u2010and\u2010effect relationship between epistaxis and hypertension is a subject of longstanding controversy. The objective of this systematic review and meta\u2010analysis was to determine the association between epistaxis and hypertension and to verify whether hypertension is an independent risk factor of epistaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>A comprehensive search was performed using the MEDLINE, EMBASE, and Cochrane Library databases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>The review was performed according to the Meta\u2010analysis of Observational Studies in Epidemiology guidelines and reported using the Preferred Reporting Items for Systematic Reviews and Meta\u2010analysis guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We screened 2768 unique studies and selected 10 for this meta\u2010analysis. Overall, the risk of epistaxis was significantly increased for patients with hypertension (odds ratio, 1.532 [95% confidence interval (CI), 1.181\u20101.986]; number needed to treat, 14.9 [95% CI, 12.3\u201019.0]). Results of the <jats:italic>Q<\/jats:italic> test and <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> statistics suggested considerable heterogeneity (<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/ohnbf08398-math-0001.png\" xlink:title=\"urn:x-wiley:01945998:media:ohnbf08398:ohnbf08398-math-0001\"\/> = 0.038, <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> = 49.3%). The sensitivity analysis was performed by excluding 1 study at a time, and it revealed no change in statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Although this meta\u2010analysis had some limitations, our study demonstrated that hypertension was significantly associated with the risk of epistaxis. However, since this association does not support a causal relationship between hypertension and epistaxis, further clinical trials with large patient populations will be required to determine the impact of hypertension on epistaxis.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817721445","type":"journal-article","created":{"date-parts":[[2017,7,25]],"date-time":"2017-07-25T16:18:37Z","timestamp":1500999517000},"page":"921-927","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Association between Hypertension and Epistaxis: Systematic Review and Meta\u2010analysis"],"prefix":"10.1002","volume":"157","author":[{"given":"Hyun Jin","family":"Min","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Chung\u2010Ang University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine Chung\u2010Ang University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geun Joo","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine Chung\u2010Ang University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Soo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Chung\u2010Ang University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,7,25]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"129","article-title":"The frequency of epistaxis in a male population sample","volume":"13","author":"Petruson B","year":"1975","journal-title":"Rhinology"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajem.2002.31577"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsha.2014.09.002"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-013-2450-z"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2008.01.018"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-6723.2004.00646.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(00)70131-4"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(95)70169-9"},{"key":"e_1_2_8_10_1","first-page":"1121","article-title":"Association between anxiety and hypertension: a systematic review and meta\u2010analysis of epidemiological studies","volume":"11","author":"Pan Y","year":"2015","journal-title":"Neuropsychiatr Dis Treat"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2700"},{"key":"e_1_2_8_13_1","unstructured":"WellsGA SheaB O\u2019ConnellD et al.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta\u2010analysis.2011.www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. 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