Essential Hypertension as an Independent Risk Factor for Erosive Esophagitis: Insights From a Single-Center Retrospective Cohort Analysis

Xiaoling Geng,1,2 Tao He,1,2 Lixia Wang,1 Zhifeng Zhang,1 Tianyu Zhao,3 Yuanjun Sun,4 Jiuyang Chang,4 Zhijun Duan1,2 1Department of Gastroenterology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People’s Republic of China; 2Dalian Central Laboratory of Integrative Neuro-Gastrointestinal Dynamics and Metabolism Related Diseases Prevention and Treatment, Dalian, People’s Republic of China; 3Liver Disease Center of Integrated Traditional Chinese and Western Medicine, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People’s Republic of China; 4Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People’s Republic of ChinaCorrespondence: Zhijun Duan, Department of Gastroenterology, First Affiliated Hospital of Dalian Medical University, Dalian Central Laboratory of Integrative Neuro-Gastrointestinal Dynamics and Metabolism Related Diseases Prevention and Treatment, Dalian, 116011, People’s Republic of China, Tel +86 83635963-3165, Email [email protected] Jiuyang Chang, Department of Cardiology, First Affiliated Hospital of Dalian Medical University, Dalian, 116011, People’s Republic of China, Tel +86 83635963, Email [email protected]: This study aimed to investigate the association between essential hypertension and the incidence of erosive esophagitis (EE) using data from a single-center hospital cohort.Methods: A total of 4844 patients who underwent gastroscopy at the First Affiliated Hospital of Dalian Medical University between June 2019 and December 2023 were included in this analysis. Participants were categorized into two groups: those with erosive esophagitis (EE) and those without, the latter comprising individuals who presented with neither reflux-related symptoms nor positive endoscopic findings. Logistic regression hazard models were used to assess the association between hypertension and EE. Correlation analyses were performed to evaluate the relationship between the severity of esophagitis and degree of hypertension.Results: Among the participants, 2359 (52.41%) were classified in the EE group, while 2305 (47.59%) were in the non-EE group. Among the individuals with EE, 821 (32.3%) had a history of hypertension, compared to 640 (27.8%) in the non-EE group. This difference was statistically significant (P < 0.05). Furthermore, hypertension was associated with a significantly increased risk of EE (odds ratio [OR]: 1.243 [95% confidence interval [CI], 1.099– 1.407], P < 0.05). After adjustments for potential confounders, hypertension was an independent risk factor for EE (OR: 1.213 [95% CI, 1.036– 1.419]; P < 0.05). Additional independent risk factors for EE included high body mass index (OR = 1.034, [95% CI: 1.017– 1.052; P < 0.05]), presence of hiatal hernia (OR = 5.722 [95% CI: 3.910– 8.376; P < 0.05]), smoking history (OR: 1.249 [95% CI, 1.072– 1.455]), and elevated albumin levels (OR = 1.046, 95% CI: 1.026– 1.066; P < 0.05).Conclusion: Essential hypertension was identified as an independent risk factor for erosive esophagitis, which suggests that individuals with essential hypertension may warrant closer monitoring for erosive esophagitis in clinical settings.Keywords: erosive esophagitis, essential hypertension, gastroesophageal reflux disease, hiatal hernia, metabolic syndrome