Risk factors for hospitalized upper or lower gastrointestinal tract bleeding in treated hypertensives

Preventive Medicine
Robert C KaplanBruce M Psaty

Abstract

We examined risk factors for hospitalized gastrointestinal bleeding among health maintenance organization (HMO) members with hypertension. 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. 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). 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 in...Continue Reading

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Citations

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