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

Wondering if abnormal bleeding, pelvic pain and leg swelling are signs of something fatal?

According to Dr Ninad Katdare, Consultant Surgical Oncologist, Jaslok Hospital & Research Centre, they may be symptoms of cervical cancer. While many may expect drastic signs such as severe pain, heavy bleeding or obvious illness, identifying certain symptoms can help with early diagnosis and treatment.

Cervical cancer develops in a women's cervix (uterus opening) due to abnormal cell growth, primarily caused by persistent HPV infection, a common infection that's passed through sexual contact.

When exposed to HPV, the body's immune system typically prevents the virus from causing damage however, in a small percentage of people, the virus can survive for years and pave the way for some cervical cells to become cancerous.

Treatment involves surgery, radiation, and chemotherapy, with early detection significantly improving outcomes, though it remains a major cancer in low-income countries. Cervical cancer can also be prevented through vaccination and regular screening (Pap/HPV tests).

Dr Katdare told News18: "In its early stages, it is often more of a whisper than a shout. As a cancer surgeon who has treated hundreds of women with gynaecological cancers, I can say with confidence that recognising these subtle cues can lead to earlier diagnosis and significantly better outcomes."

He recommends looking out for these early signs:

1. Intermenstrual Bleeding

2. Changes In Vaginal Discharge

But Dr Katdare warns that any sudden or abnormal changes in discharge may be a symptom of the cancer. “Because discharge issues are commonly linked to infections, many women self-medicate or delay seeking care," he said. “While infections are far more common, chronic or unusual discharge especially in older women requires thorough evaluation."

Discharge may become persistent, watery, foul-smelling, or tinged with blood or pink, brown, or rust-colored if you're suffering from this kind of cancer.

3. Persistent Pelvic Pain

Consistent pelvic pain particularly that occurs outside the menstrual cycle or during sexual intercourse should be a point of concern. According to Dr Katdare, "Pain during intercourse, or dyspareunia, is especially important. It should not be dismissed as ‘just dryness’ or an age-related change. In cervical cancer, this pain may result from inflammation or tumour growth involving the cervix and surrounding tissues."

4. Leg Swelling

5. Urinary And Bowel Symptoms

“These symptoms are often evaluated in isolation because they don’t seem related to the cervix," said Dr Katdare, “which can delay the correct diagnosis."

Ultimately the expert advised: "“Cervical cancer does not always announce itself loudly,. Sometimes, it leaves silent clues. The sooner you listen to them, the better the outcome. If something feels ‘off,’ trust that instinct and seek medical advice. Early action can make the difference between a curable disease and a life-altering diagnosis."

Angina, a symptom of coronary artery disease, is a type of chest pain caused by the heart muscle not getting enough oxygen-rich blood, usually due to narrowed coronary arteries from plaque buildup.

Itis often described as squeezing, pressure, or heaviness in the chest, potentially radiating to arms, neck, jaw, or back and at times, can feel like indigestion. Experiencing an angina is warning sign of heart disease, not of a heart attack.

However, Shexiang Tongxin Dropping Pill (STDP), a Chinese traditional medicine that can help ease angina pain as it helps improve blood flow and protects heart microcirculation through its anti-inflammatory, anti-oxidant and anti-apoptotic (promoting cell survival) characteristics, according to an EMJ study.

What Is Shexiang Tongxin Dropping Pill?

In this a randomized controlled study, 200 adults with angina and coronary slow flow phenomenon were assigned to receive either STDP or a placebo. The study measured coronary blood flow using corrected TIMI frame count (CTFC).

Patients who received STDP had improved blood flow in two major coronary arteries, while those given placebo showed no improvement. The improvement with STDP was significantly greater than with placebo.

The scientists concluded that using STDP to increase blood flow in the body was beneficial with no major safety concerns reported during the trial, allowing them to conclude that this Chinese medication can help the flow of blood through the heart’s smallest blood vessels, which supply oxygen and nutrients to the heart muscle with no side-effects.

Researchers are yet to conclude how the medication works and helps the heart.

Coronary Artery Disease: The Silent Killer

Despite being as a common heart disease, coronary artery disease (CAD) develops over years and has no clear signs and symptoms apart from chest pain and a heart attack. The illness begins due to a buildup of fats, cholesterol and other substances known as plaque in and on the artery walls.

Over time, this can cause narrowing or blockage of the coronary arteries and block the supply of oxygen-rich blood to heart which can lead chest pain (angina), shortness of breath and ultimately, heart attacks.

Typically, those above the age of 45, having a biological family member with heart disease, lack of sleep, smoking, consuming saturated fats along with other autoimmune diseases such as lupus and rheumatoid arthritis can increase the risk of developing CAD.

Treatment options may include medicines and surgery. Eating a nutritious diet, getting regular exercise and not smoking can help also prevent CAD and the conditions that can cause it.

Nearly one in 10 Indian adults suffer from CAD and about two million people die from the disease annually. Apart from this, about 18 to 20 million American adults aged 20 and older are also affected about the disease.

How Much You Should Exercise To Prevent CAD?

Moreover, regular exercise can also reduce the risk of Type 2 diabetes, high blood pressure, dementia and Alzheimer’s, several types of cancer. It can also help improve sleep, cognition, including memory, attention and processing speed.

Dr Hayes recommends opting for a cardiac evaluation such as an electrocardiogram, or EKG; stress test; a cardiac MRI or CT scan to generate images of your heart if you notice changes in your ability to exercise or cannot perform consistent levels of exercise.

In early January, the U.S. Centers for Disease Control and Prevention (CDC) made one of the most significant changes to childhood vaccination policy in decades. Routine vaccination is no longer universally recommended for six diseases, including rotavirus, influenza, meningococcal disease and hepatitis A. The move follows a directive from President Donald Trump’s administration to reassess vaccine schedules and align them with what officials called “international consensus.”

Supporters of the change describe it as a step toward informed consent and transparency. Many public health experts see it very differently. They argue that the science behind the decision is selective, the process breaks with long-standing norms, and the consequences may only become clear years later.

So are these vaccines actually necessary, and is removing them from compulsory recommendation a reasonable move? Health and Me ran a fact check to see whether the four vaccines removed from the CDC universal guidelines would actually be a "better thing", as the Health Secretary and long time vaccine critic Robert F Kennedy Jr says.

Read: Children Getting Fewer Vaccine May Be A 'Better Thing', Says RFK Jr, As US Struggles With Rise In Flu Activity

What Exactly Changed With The CDC Vaccination

Until recently, the CDC recommended routine childhood vaccination against 17 diseases. That number has now dropped to 11. Vaccines for rotavirus, influenza, meningococcal disease, hepatitis A, hepatitis B and COVID-19 are no longer universally recommended for all children. Instead, they fall under shared clinical decision-making, meaning parents can still opt for them after discussion with a healthcare provider.

Importantly, this does not mean the vaccines are banned or unavailable. Insurance coverage remains largely unchanged for now, and vaccines remain recommended for children at higher risk.

The larger concern raised by experts is not access, but messaging. Universal recommendations have historically been one of the strongest drivers of vaccine uptake.

Read More: CDC Vaccine Schedule: Coverage Falls From 17 to 11 Diseases For Children

A Break From the Usual Scientific Process

Traditionally, changes to the U.S. vaccine schedule go through the CDC’s Advisory Committee on Immunization Practices, a panel of independent experts who review evidence publicly over months. This time, that process was bypassed.

Instead, the decision relied on a 33-page internal assessment prepared by two political appointees. Several experts criticized both the lack of transparency and the narrow interpretation of evidence.

Dr. Paul Offit, a pediatrician and vaccine expert at Children’s Hospital of Philadelphia, described the process as federal officials making sweeping decisions behind closed doors, without public input or broad expert review.

Rotavirus: Rare Deaths, Heavy Hospital Burden

Rotavirus causes severe diarrhea and vomiting in infants and young children, often leading to dehydration. Before routine vaccination began in 2006, an estimated 55,000 to 70,000 U.S. children were hospitalized each year due to rotavirus.

The administration justified dropping the universal recommendation by emphasizing low mortality rates. However, CDC researchers previously estimated 20 to 60 deaths annually in the pre-vaccine era. Experts say focusing narrowly on death counts ignores the very real suffering and healthcare burden the virus caused.

Offit, who helped develop one of the vaccines, noted that most pediatric residents today have never seen a child hospitalized with severe rotavirus dehydration. That absence, he argues, is proof of success, not irrelevance.

Meningococcal Disease: Rare but Devastating

Meningococcal disease is uncommon, but when it strikes, it can be deadly within hours. Even with treatment, about 15 percent of patients die, and up to 20 percent suffer permanent complications such as amputations or hearing loss.

The administration cited low incidence and World Health Organization thresholds to justify removing the universal recommendation. But experts counter that low incidence is precisely what vaccination programs aim to achieve.

Dr. David Stephens of Emory University pointed out that most high-income countries still recommend meningococcal vaccines, even with similarly low disease rates. He also warned that recent U.S. data show a resurgence, with 2024 recording the highest number of cases in over a decade.

Modeling studies suggest that U.S. vaccination programs have already prevented hundreds of cases and dozens of deaths. Removing universal recommendations, experts warn, risks reversing those gains.

Influenza: The Limits of Clinical Trials

Annual flu vaccination for children has been recommended since 2008, based on evidence that children both suffer from influenza and play a major role in spreading it.

The administration argued that randomized controlled trials have not proven flu vaccines reduce hospitalizations or deaths in children. What it did not emphasize is that such trials are not designed to detect rare outcomes like death.

Dr. Mark Loeb of McMaster University explained that proving mortality benefits would require trials involving millions of children, which is not feasible. Instead, real-world observational studies are used.

Those studies consistently show that flu vaccination reduces hospitalizations in children. A 2024 review in the New England Journal of Medicine estimated a 67 percent reduction in pediatric hospital admissions. Experts say dismissing this evidence reflects a misunderstanding of how vaccine effectiveness is measured.

Also Read: RSV Vaccine Has Benefits, Reveals Study Amid CDC's Changed Guidelines On Childhood Vaccines

Hepatitis A: Protecting Others by Vaccinating Children

Hepatitis A rarely causes severe illness in young children, which is precisely why childhood vaccination works. Children often spread the virus silently to adults, who face much higher risks of liver failure and death.

Dr. Noele Nelson, a former CDC epidemiologist, explained that vaccinating children interrupts this transmission chain and provides lifelong immunity. She warned that reducing childhood vaccination could recreate the conditions that once fueled adult outbreaks.

Claims that hepatitis A vaccines lack adequate safety data were also disputed. Clinical trials and decades of post-licensure monitoring have found no unexpected safety concerns, according to Nelson and other experts.

Are These Changes Scientifically Justified?

Public health experts broadly agree that these vaccines are not perfect and that honest discussions about risks and benefits matter. Where they strongly disagree is the idea that low disease rates or ethical limits on trial design justify weakening universal recommendations.

Low incidence, experts emphasize, is not a reason to stop vaccinating. It is evidence that vaccination works.

Whether the consequences of this policy shift emerge in five years or ten, many experts fear the costs will be paid quietly, through preventable hospitalizations, outbreaks and deaths that no longer make headlines but never needed to happen in the first place.