Influence of Hypertension and Other Risk Factors on the Onset of Sublingual Varices

Abstract

Background: Sublingual varices (SV) are dilatations of tortuous veins that increased with age. Previous studies showed that this pathology could be correlated to some risk factors such as hypertension, age, gender and diabetes mellitus. The goal of the study was to evaluate the relationship between SV and different grades of hypertension as well as other risk factors partially verifying the results of previous studies on a greater number of subjects and extending the analysis to new risk factors such as dyslipidemia, obesity and antihypertensive therapy, modelling a possible dependence of SV on all these factors.Methods: The study was conducted on 1008 subjects (284 with and 724 without sublingual varices). The blood pressure was measured in office condition and, to exclude subjects with white coat syndrome or masked hypertension, also using a 24h Holter pressure monitor. Hypertensive subjects were divided in resistant, drugs controlled (compensated) and patients with prior unknown hypertension (new diagnosed) groups. The presence or absence of SV as well as of the risk factors was assessed clinically. We tested the influence of age on the presence of SV by using the chi-square test, and evaluated the relation between each risk factor and SV by the Cochran-Mantel-Haenszel test. Finally, we carried out a multivariate regression tree analysis in order to predict the presence of SV.Results: We confirmed the influence of age on SV and found a significant relationship between SV and both the compensated and resistant hypertension grades. Moreover, we highlighted a relationship between SV and dyslipidemia, only in subjects with new diagnosed hypertension, and between SV and smoking, in new diagnosed hypertensive subjects. On the other hand, the regression tree showed a classification accuracy of about 75% using as variables the hypertension grades, the age and the antihypertensive treatment.Conclusions: The study confirmed the SV dependence on various risk factors like age, hypertension and smoking, highlighting a new link with dyslipidemia and new relations depending on the hypertensive grades. Finally, despite the good accuracy shown by the prediction tree model, further parameters are to be considered to improve the sensitivity of the prognostic indicator.