Guidelines of the French Society of Otorhinolaryngology (SFORL). Epistaxis and high blood pressure.

Abstract Objectives The authors present the guidelines of the French Oto-Rhino-Laryngology – Head and Neck Surgery Society ( Societe Francaise d’Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou : SFORL) on epistaxis in high blood pressure. Methods A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members’ individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. Results It is recommended to measure the blood pressure of patients in acute-phase epistaxis (Grade A); to control high blood pressure medically in the acute phase of bleeding, to reduce its duration; to monitor blood pressure at the waning of nosebleed; and to control high blood pressure medically in the waning phase to reduce the risk of recurrence. In case of persistent high blood pressure on waning of severe epistaxis, it is recommended to prescribe cardiovascular evaluation to screen for underlying hypertensive disease (Grade B).