It was a typical morning. My mother was getting ready; this was her usual routine: bustling around the house. When she suddenly stopped and shouted, blood was oozing from her nose. As kids, my siblings and I were terrified. We scrambled to help, but it wasn't until later that we learned the cause of that alarming moment: high blood pressure. That day was our first lesson in the silent yet powerful effects of hypertension. Nosebleeds, or epistaxis, are common, and nearly everyone experiences at least one in their lifetime.

While most are minor and often caused by dry air or irritation, some can signal underlying health concerns. One recurring question is whether high blood pressure causes nosebleeds or is merely coincidental.

Where Exactly Does a Nosebleed Occur?

The nose is covered by a rich plexus of small blood vessels, making it prone to bleeding. Most nosebleeds are anterior in origin, occurring at the front of the nose, and are relatively benign. They often occur because of irritants such as dry air, frequent nose-blowing, or trauma.

On the other hand, posterior nosebleeds are caused by a source that is located deeper within the nasal cavity. They are less common but more severe, as the blood tends to flow backward into the throat, making them more difficult to control. Common causes of posterior nosebleeds include trauma, medical conditions, or high blood pressure.

Connection Between Nosebleeds and High Blood Pressure

Hypertension is the condition whereby the pressure of blood against the arterial walls is consistently too high. Over time, this may damage the fine blood vessels in the nose, causing them to rupture more easily.

Significant studies have shown a strong relationship between hypertension and severe cases of nosebleeds necessitating urgent care. A certain study showed that patients diagnosed with high blood pressure had 2.7-fold increased chances of having nosebleeds that were not slight.

However, it should be noted that mild hypertension by itself does not cause nosebleeds. Nosebleeds are more likely to happen during a hypertensive crisis when the blood pressure suddenly rises to above 180/120. A hypertensive crisis can also have other symptoms such as a severe headache, shortness of breath, and anxiety. Therefore, it is considered a medical emergency.

Why Does Hypertension Increase the Risk?

Chronic hypertension makes the walls of blood vessels weaker and less elastic, which easily causes them to tear. In the nose, this is especially vulnerable because the blood vessels are close to the surface. Sudden surges in blood pressure, such as in a hypertensive crisis, can cause tears in these weakened vessels, resulting in nosebleeds.

While hypertension is a contributing cause, nosebleeds occur infrequently as the only manifestation of high blood pressure. This makes regular monitoring for blood pressure all the more crucial, as hypertension has the reputation of being the "silent killer" since people often do not present symptoms until the disease has run its course.

Other Causes of Nosebleeds

• Dry Air: Cold weather or house heating dries out membranes that line the nose, hence susceptible to cracking.
• Trauma: Blows in the nose, nose picking or excessive nose blowing can traumatize blood vessels.
• Intrinsic Disease: Liver disease and kidney disease and drug therapy that affect clotting such as blood thinners enhance the risk of nose bleeding.
• Foreign Bodies: Children especially tend to insert objects up their noses, which can be irritating and bleed.
• Allergies or Infections: Chronic nasal inflammation resulting from allergies or colds causes irritation to the nasal mucosa.

Managing Nosebleeds at Home

For most nosebleeds, you can manage them yourself at home:

1. Sit up and lean slightly forward to prevent swallowing blood.

2. Press your nostrils together for at least 10 minutes.

3. Use a cold compress on the bridge of your nose to constrict blood vessels.

4. If the bleeding continues, use a nasal decongestant spray.

Consult a doctor if the bleeding persists beyond 20 minutes, is heavy, or follows a head injury.

Preventing Nosebleeds

Preventive measures can decrease the incidence of nosebleeds:

• Use a humidifier to maintain moisture in the air.
• Apply saline sprays or gels to keep nasal passages hydrated.
• Avoid nasal trauma by being gentle when blowing your nose.

For patients with hypertension, managing blood pressure is the best way to minimize the risk of complications. A combination of lifestyle changes, such as maintaining a healthy diet, regular exercise, and prescribed medications, can help keep blood pressure in check.

When to Worry About Nosebleeds

Most nosebleeds are harmless, but they can sometimes be signs of an underlying health condition. In adults with high blood pressure, frequent or severe nosebleeds should never be ignored. A health provider should be consulted in order to rule out any serious conditions and ensure appropriate treatment.

Regular check-ups, a healthy lifestyle, and awareness about the relationship between nosebleeds and high blood pressure would go a long way to protect your health. Indeed, prevention is always better than cure.

Epistaxis and hypertension. Post Graduate Medical Journal. 1977

Diabetes at 35 and diabetes at 60 are not the same. As we grow older, the way diabetes presents, the complications we worry about and even the way we treat it can change. This is why diabetes care after 60 needs to look beyond a single blood test.

HbA1c remains an important measure of average blood sugar over the previous few months. But for an older adult, it cannot be the only measure of good diabetes care.

Diabetes Symptoms Can Be Silent in Older Adults

One of the challenges with diabetes in older people is that symptoms may not always be obvious. A person may not experience the typical excessive thirst, frequent urination or unexplained weight loss, even when blood sugar levels are high.

At the same time, older adults can be more vulnerable to diabetes-related complications affecting the eyes, kidneys, nerves, heart and blood vessels. Vision problems are particularly important because loss of vision can directly affect mobility, confidence and independence.

This makes regular screening essential, even when a person feels completely well.

The Same HbA1c Target Does Not Suit Everyone

There is no single HbA1c cut-off that is appropriate for every older adult. Treatment goals need to consider age, overall health, cognitive function, physical function, existing complications and the person's ability to manage treatment independently. Current diabetes standards specifically recommend individualising glycaemic goals in older adults.

For example, a healthy 65-year-old who is active and independent may have very different treatment goals from an 80-year-old who is frail, has multiple medical conditions or needs help with daily activities.

The goal should be good blood sugar control without causing unnecessary harm, particularly hypoglycaemia.

Treatment After 60 May Need to Be Different

As people age, kidney function can change, meals may become irregular and multiple medicines may be prescribed for different conditions. These factors can increase the risk of low blood sugar and make complex treatment plans harder to follow.

Therefore, doctors may need to review medicines regularly and simplify treatment when appropriate. The focus should be on finding a treatment plan that is effective, safe and practical for that individual.

Look Beyond Blood Sugar

A comprehensive diabetes review in an older adult should also consider:

• Eye and retinal health
• Kidney function
• Blood pressure and cholesterol
• Foot and nerve health
• Risk of hypoglycaemia
• Nutrition and unintended weight loss
• Muscle strength and mobility
• Memory and cognitive function
• Risk of falls
• Ability to take medicines and manage diabetes independently

The aim is not simply to produce a better HbA1c report. It is to prevent complications while helping the person remain active and independent.

Nutrition and Exercise Should Protect Independence

Older adults with diabetes need adequate nutrition, particularly protein and other nutrients needed to maintain muscle mass. Excessive dietary restriction can sometimes do more harm than good.

Physical activity is equally important. Walking, strength exercises and balance activities, when medically appropriate, can help maintain mobility and reduce the risk of losing independence.

Growing Older Well With Diabetes

Diabetes management after 60 should be personalised and regularly reassessed. What is appropriate at 60 may not be appropriate at 75 or 85.

As we mark the International Day of Older Persons, the message is simple: living well with diabetes in later life is about much more than achieving a particular HbA1c.

We need to treat the person, not just the number — protecting their health, safety, dignity and independence as they grow older.

By Dr. Uthra S, Senior Consultant, Dr. Mohan’s Diabetes Specialties Centre

Changes in voice pitch, volume or clarity in older adults could be an early warning sign of cognitive decline, according to a new analysis.

The study, published in the Journal of Voice, found that older adults who experienced a decline in voice quality had a higher risk of cognitive impairment or dementia than those without a voice disorder.

Voice Disorders And Higher Dementia Risk

The study tracked the health of more than 833,000 older Americans. Researchers found that people with a voice disorder had a 58% higher risk of cognitive impairment or dementia than those without voice problems.

The risk was even higher among people who had both a voice disorder and hearing loss, a well-recognized risk factor for Alzheimer’s disease.

Who Should Worry?

Also read: Brain Health After 40: How Diabetes, Menopause And Early Detection Affect Dementia Risk | World Alzheimer’s Day

A brief episode of hoarseness does not mean that a person is developing dementia.

However, persistent or noticeable changes in the voice, particularly when accompanied by hearing loss, may warrant a medical evaluation and, where appropriate, an assessment of cognitive health.

“We found the strongest link with dementia among patients experiencing a voice disorder and hearing loss,” said study author Dr. Robert Sataloff, a professor and chair at Drexel University’s College of Medicine.

“Importantly, we found that those with a voice disorder and no hearing loss were at greater risk than patients who experience hearing loss only. It may be valuable for many of these patients to talk with an otolaryngologist who can arrange a cognitive assessment to help patients develop an appropriate care plan.”

Why Voice Changes Can Signal Cognitive Decline?

Read More: Muscle Loss In Middle Age May Signal Dementia Risk, Study Finds

The researchers speculate that voice disorders may contribute to cognitive decline by limiting social interaction, which can also be affected by hearing loss.

People who have difficulty speaking or hearing may avoid social gatherings or group activities because they feel embarrassed or uncomfortable about their limitations. However, social engagement can help keep the ageing brain active by providing ongoing mental stimulation.

“If you have a voice disorder that impacts how your voice sounds or if it’s painful when you attempt to talk or sing, it’s only natural to participate less often in brain-supporting social or other engaging activities,” Dr. Sataloff said.

Speaking less may mean less social and cognitive stimulation, which could potentially contribute to dementia risk. However, the researchers also noted another possibility: changes in the brain associated with dementia could themselves contribute to voice problems. However, this has not been directly studied.

Voice Problems Can Have Treatable Causes

Most people with voice disorders will not go on to develop Alzheimer’s disease. Voice changes can have several other causes, including thyroid problems and cysts on the vocal cords, some of which can be treated effectively.

Speech therapists can also help people with impaired speech communicate more effectively and confidently.

Seeking medical attention for persistent voice changes can therefore help identify treatable causes and determine whether further evaluation, including a cognitive assessment, is needed.

As the 2026-27 flu season begins in the US, doctors are reminding people that influenza can cause more than just cough, fever and a runny nose. Symptoms can come on suddenly and affect the entire body, with some patients also developing gastrointestinal symptoms.

During the 2025-2026 flu season, influenza caused at least 32 million illnesses, 390,000 hospitalizations and 24,000 deaths in the US, according to preliminary data from the Centers for Disease Control and Prevention (CDC).

According to the World Health Organization, from February through August 2026, influenza A(H1N1)pdm09, A(H3N2) and influenza B viruses circulated across regions. Influenza A viruses predominated in most regions, while influenza B dominated in Northern and Western Africa, North America and Eastern Asia.

While it is too early to know what the season ahead will look like, knowing the range of flu symptoms can help people recognize the infection. These include the classic symptoms of sudden fever, chills, body aches and extreme fatigue, as well as vomiting and diarrhea in some children.

Flu Symptoms Can Come On Suddenly

Also read: WHO Sets 2027 Flu Vaccine Strains; US States Can Now Order Free COVID Shots For Kids

Influenza commonly affects the nose, throat and lungs, but its symptoms can be widespread.

The most common symptoms include:

• Fever

• Chills

• Body aches

• Extreme fatigue

• Headache

• Sore throat

• Runny or stuffy nose

• Cough

Family physician Carlos Galindo at Texas Health Family Care said fever, chills and body aches are the classic flu combination. People may also develop a sore throat, runny nose and headache, according to the American Medical Association.

Unlike the gradual tiredness that can accompany a cold, flu-related fatigue can be intense.

Galindo described it as significant lethargy and malaise, with some patients feeling completely drained.

Watch For Severe Body Aches And Fatigue

One of the key features doctors want people to recognize is how quickly influenza can make someone feel unwell.

Family physician Christopher Zipp of Atlantic Health in Morristown, New Jersey, said flu symptoms can develop over just a few hours, with fever, chills and body aches appearing suddenly.

However, flu symptoms can overlap with those of other respiratory infections, so symptoms alone cannot always confirm that someone has influenza.

Read More: Fall Vaccines 2026: US Doctors Issue COVID, Flu And RSV Jab Guidance

Children Can Have Vomiting And Diarrhea

Flu symptoms can also differ between children and adults. While fever, chills, body aches and respiratory symptoms are common, children may also develop gastrointestinal symptoms such as vomiting and diarrhea.

These symptoms can occur alongside cough, sore throat or other signs of respiratory infection.

When Can Flu Become Serious?

For most people, influenza is an unpleasant but temporary illness. However, it can sometimes lead to complications such as pneumonia and hospitalization, particularly in people with underlying health conditions.

Symptoms that become severe or worsen rather than improve warrant medical attention, especially among people at higher risk of complications.

In the US, many flu cases are seen between January and March, although influenza can circulate outside the peak season as well.

Doctors generally recommend flu vaccination around September or October to build protection before activity increases. It takes about two weeks for the body to develop protection after vaccination. Flu vaccination has been shown to reduce flu-related doctor visits by about 40% to 60%.