Essential Hypertension <-> Dieulafoy Lesion

Comorbidity UNKNOWN CANDIDATE

Split out of `kb/disorders/Dieulafoy_Lesion.yaml`'s `environmental:` block (dismech#8302, one of the four "environmental block asserts something the pathophysiology block cannot receive" instances tracked there): hypertension was listed as an "exposure" with no route to either of the entry's two pathophysiology nodes (both describe the congenital vascular anomaly itself, not its acquisition or triggering). It is a comorbidity/host-attribute state, the same category error #8185 tracks, and is a first-class `Disease` entry in its own right (`kb/disorders/Essential_Hypertension.yaml`). Directionality is UNKNOWN rather than A_BEFORE_B/RISK: the only source is a within-case comorbidity proportion from a 101-case systematic review of rectal Dieulafoy lesion (mean age 66±17), with no comparison population. That is consistent with hypertension simply reflecting the age profile of patients who present with GI bleeding, and the source itself proposes no mechanism connecting hypertension to submucosal-artery caliber persistence or mucosal erosion. Recording an inferred `RISK` direction or a mechanistic hypothesis here would assert more than the evidence supports (per the dismech#8195 review precedent on over-claiming from within-case prevalence). The source paper does not specify whether cases were essential vs. secondary hypertension; `Essential_Hypertension` is used as the presumptive default since essential hypertension accounts for the large majority of hypertension in the general population. Supersedes the `review_notes:` no-link waiver dismech#10980 recorded on the removed `environmental:` entry under dismech#8085. That waiver answered a different question — whether to run an `influences_mechanisms` edge from the exposure to a pathophysiology node — and answered it no, on the reasoning that "no cited sentence connects blood pressure to it or to its erosion." That reasoning is the case for this entry: a within-case comorbidity proportion is a co-occurrence observation, which is what a comorbidity record models and what an environmental exposure does not. The no-link decision is preserved here as `directionality: UNKNOWN` with no mechanistic hypothesis, so nothing #8085 settled is reopened by the move.

Disease A

Essential Hypertension

Slug:Essential_Hypertension

Disease B

Dieulafoy Lesion

Slug:Dieulafoy_Lesion

Causal Mechanism Graphs

Essential Hypertension

graph LR
    Immune_and_Inflammatory_Activation["Immune and Inflammatory Activation"]
    Obesity["Obesity"]
    High_Sodium_Diet["High Sodium Diet"]

    High_Sodium_Diet --> Immune_and_Inflammatory_Activation
    Obesity --> Immune_and_Inflammatory_Activation

    style Immune_and_Inflammatory_Activation fill:#dbeafe
    style Obesity fill:#dcfce7
    style High_Sodium_Diet fill:#dcfce7

Association Signals

Signal 1

Population:Systematic review of 101 published adult rectal Dieulafoy's lesion cases (MEDLINE, Cochrane, Embase, Scopus), mean age at presentation 66±17 years; within-case comorbidity proportion, no comparison/control population.

Temporal: A before B: , B before A: , Same time:

PREVALENCE: 0.29

CI: -

FDR:

Proportion of the 101-case rectal Dieulafoy lesion series reporting hypertension as a major underlying disorder. Unadjusted for age and with no comparison population, so this corroborates co-occurrence in an elderly bleeding-presentation cohort rather than establishing an elevated risk relative to the general population.

PMID:35243119 (SUPPORT)

Source: HUMAN_CLINICAL

"Major underlying disorders were hypertension 29%, diabetes mellitus 21%, and chronic kidney disease 16%."

Reports hypertension as the most frequent underlying comorbidity among a systematic review cohort of rectal Dieulafoy lesion cases.

Raw YAML

Show YAML

name: com_Essential_Hypertension__Dieulafoy_Lesion
creation_date: "2026-08-16T00:00:00Z"
curation_status: CANDIDATE
notes: >-
  Split out of `kb/disorders/Dieulafoy_Lesion.yaml`'s `environmental:` block
  (dismech#8302, one of the four "environmental block asserts something the
  pathophysiology block cannot receive" instances tracked there): hypertension
  was listed as an "exposure" with no route to either of the entry's two
  pathophysiology nodes (both describe the congenital vascular anomaly itself,
  not its acquisition or triggering). It is a comorbidity/host-attribute
  state, the same category error #8185 tracks, and is a first-class `Disease`
  entry in its own right (`kb/disorders/Essential_Hypertension.yaml`).

  Directionality is UNKNOWN rather than A_BEFORE_B/RISK: the only source is a
  within-case comorbidity proportion from a 101-case systematic review of
  rectal Dieulafoy lesion (mean age 66±17), with no comparison population.
  That is consistent with hypertension simply reflecting the age profile of
  patients who present with GI bleeding, and the source itself proposes no
  mechanism connecting hypertension to submucosal-artery caliber persistence
  or mucosal erosion. Recording an inferred `RISK` direction or a mechanistic
  hypothesis here would assert more than the evidence supports (per the
  dismech#8195 review precedent on over-claiming from within-case
  prevalence). The source paper does not specify whether cases were essential
  vs. secondary hypertension; `Essential_Hypertension` is used as the
  presumptive default since essential hypertension accounts for the large
  majority of hypertension in the general population.

  Supersedes the `review_notes:` no-link waiver dismech#10980 recorded on the
  removed `environmental:` entry under dismech#8085. That waiver answered a
  different question — whether to run an `influences_mechanisms` edge from the
  exposure to a pathophysiology node — and answered it no, on the reasoning
  that "no cited sentence connects blood pressure to it or to its erosion."
  That reasoning is the case for this entry: a within-case comorbidity
  proportion is a co-occurrence observation, which is what a comorbidity
  record models and what an environmental exposure does not. The no-link
  decision is preserved here as `directionality: UNKNOWN` with no mechanistic
  hypothesis, so nothing #8085 settled is reopened by the move.

disease_a:
  slug: Essential_Hypertension
  preferred_term: essential hypertension
  term:
    id: MONDO:0001134
    label: essential hypertension

disease_b:
  slug: Dieulafoy_Lesion
  preferred_term: Dieulafoy lesion
  term:
    id: MONDO:0001427
    label: Dieulafoy lesion

directionality: UNKNOWN
effect_direction: UNKNOWN

association_signals:
- source: LITERATURE
  method: LITERATURE_ASSOCIATION
  population: >-
    Systematic review of 101 published adult rectal Dieulafoy's lesion cases
    (MEDLINE, Cochrane, Embase, Scopus), mean age at presentation 66±17
    years; within-case comorbidity proportion, no comparison/control
    population.
  directionality: UNKNOWN
  statistics:
    metrics:
    - metric_type: PREVALENCE
      metric_value: 0.29
      notes: >-
        Proportion of the 101-case rectal Dieulafoy lesion series reporting
        hypertension as a major underlying disorder. Unadjusted for age and
        with no comparison population, so this corroborates co-occurrence in
        an elderly bleeding-presentation cohort rather than establishing an
        elevated risk relative to the general population.
    evidence:
    - reference: PMID:35243119
      reference_title: "Rectal Dieulafoy's lesion: a comprehensive review of patient characteristics, presentation patterns, diagnosis, management, and clinical outcomes."
      supports: SUPPORT
      evidence_source: HUMAN_CLINICAL
      snippet: "Major underlying disorders were hypertension 29%, diabetes mellitus 21%, and chronic kidney disease 16%."
      explanation: >-
        Reports hypertension as the most frequent underlying comorbidity
        among a systematic review cohort of rectal Dieulafoy lesion cases.

Source:GitHub