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

A small implanted device that stimulates the vagus nerve may offer substantial and lasting relief for people with severe treatment-resistant depression, according to a large multicenter clinical trial.

The findings, published in the International Journal of Neuropsychopharmacology, showed that improvements in depressive symptoms, quality of life, and daily functioning were sustained for at least two years in most patients who responded to treatment.

Notably, more than 20% of treated participants (39 patients) were in remission after two years, meaning their depressive symptoms had improved enough for them to function normally in daily life.

"We were shocked that one in five patients was effectively without depressive symptoms at the end of two years," said lead author Charles Conway, professor of psychiatry and director of Washington University's Treatment Resistant Mood Disorders Center.

Depression Remains A Major Health Burden

Also read: Bryan Johnson Blames Sugary Cereals, Soda and Stress for His Autoimmune Disease; Shares Treatment Plan

Earlier this week, Republican Tom Kean Jr. revealed that he had been diagnosed with depression, explaining his absence from public life for more than 100 days.

He is far from alone. About 20% of U.S. adults experience major depression during their lifetime. While most people improve after antidepressants or psychotherapy, up to one-third develop treatment-resistant depression, in which standard treatments fail to provide adequate relief.

Study Focused on the Most Severe Cases

The RECOVER trial, led by researchers at Washington University School of Medicine in St. Louis, enrolled nearly 500 patients across 84 sites in the US. On average, participants had:

• Lived with depression for 29 years
• Tried 13 unsuccessful treatments
• Undergone therapies including electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS)
• Three-quarters were too ill to work.

"We believe the sample in this trial represents the sickest treatment-resistant depressed patient sample ever studied in a clinical trial," Conway said.

"There is a dire need to find effective treatments for these patients, who often have no other options. With this kind of chronic, disabling illness, even a partial response to treatment is life-altering, and with vagus nerve stimulation, we're seeing that benefit is lasting," he added.

Read More: Wegovy Weight Loss Pill Available in UK Pharmacies From Today: All You Should Know

Benefits Lasted for Two Years

The VNS Therapy System, manufactured by LivaNova USA, Inc., involves implanting a small device beneath the skin of the chest. The device delivers carefully calibrated electrical pulses to the left vagus nerve, which serves as a major communication pathway between the brain and internal organs.

Although every participant received an implant, only half had their devices activated during the first year, allowing researchers to compare outcomes.

The latest analysis focused on 214 patients whose devices were activated from the beginning of the study.

Among them:

• About 69% (147 patients) achieved a meaningful improvement in at least one outcome after 12 months.
• More than 80% of those responders maintained or improved those benefits after 24 months.
• Among patients with a substantial response after one year, 92% continued to experience benefits two years later.

Conway noted that even a 30% improvement can dramatically change the lives of patients with severe depression, who often struggle to carry out basic daily activities and face a higher risk of hospitalization or early death.

READ: Donald Trump Posts AI Video of Himself Treating Critics for 'Derangement Syndrome'

Some Patients Improved Later

The study also found that recovery may take longer for some people.

Nearly one-third of participants who had not responded after the first year reported meaningful improvements by the end of the second year, suggesting prolonged stimulation may continue to produce benefits.

Researchers also observed consistently low relapse rates among patients who improved, particularly among those with the strongest responses.

In the last few years, biohacker and longevity entrepreneur Bryan Johnson has become famous for maintaining a picture-perfect health in order to defy the norms of aging.

But this week, Johnson shared a shocking health update with his followers. He said that he has been diagnosed with Autoimmune Gastritis (AIG), a chronic autoimmune disease in which the immune system attacks the stomach lining. He said, “My stomach is eating itself.”

Bryan Johnson's Diagnosis Of Autoimmune Gastritis

Despite years of optimizing his body, Bryan’s Johnson Autoimmune Gastritis diagnosis shocked the internet. While his strict routines, meticulous diet, and million-dollar anti-ageing protocol continue to inspire millions, they also receive equal amounts of skepticism and criticism.

Johnson recently revealed that he had struggled with persistently low iron stores for nearly 11 years, despite taking supplements.

Also Read: Legionnaires' Disease Outbreak Grips NYC After At Least 14 Cases Reported Across 2 Neighborhoods

He said that a detailed evaluation confirmed Autoimmune Gastritis, an illness that damages the acid-producing cells of the stomach. The condition can impair absorption of iron and vitamin B12 and may increase the long-term risk of gastric cancer.

He also disclosed that he has autoimmune thyroid disease, suggesting that multiple autoimmune conditions may be interconnected in his case.

Amid his diagnosis, Johnson's journey raises a practical question: Which of his longevity habits are genuinely backed by science and worth adopting, and which remains experimental?

Five Bryan Johnson Habits That Are Actually Worth Copying

Prioritising Sleep

Among all longevity interventions, sleep has the strongest scientific backing. Johnson consistently aims for a regular sleep schedule and treats sleep as a primary health priority. Unlike expensive biohacks, sleeping 7 to 9 hours consistently benefits almost everyone.

Research has linked quality sleep with:

• Better immune function

• Lower cardiovascular risk

• Improved memory

• Better metabolic health

• Reduced inflammation

Read more: Ebola Deaths In DRC Top 500 With At Least 1528 Cases Reported; What Makes This Outbreak Different & Deadlier?

Eating Whole, Plant-Based Foods

Johnson follows a predominantly plant-based diet rich in vegetables, legumes, nuts, seeds, and healthy fats.

While optimal health is not connected with veganism, evidence supports that diets including vegetables, fruits, whole grains, beans, and nuts are associated with lower risks of heart disease, diabetes, and several cancers.

Exercising Consistently

Johnson combines strength training, cardiovascular exercises, mobility exercises, and walking throughout the day to stay healthy and fit.

Research, too, recommends at least 150 minutes of moderate physical activity per week to enhance longevity.

Tracking Basic Health Markers

One of Johnson's greatest takeaways from his blueprint is tracking basic health markers. His long-standing low ferritin eventually prompted further investigation that disclosed his autoimmune gastritis.

It reminds us that routine health check-ups often identify silent diseases before symptoms appear. For most people, daily monitoring should include:

• Blood pressure

• Blood sugar

• Cholesterol

• Iron levels

• Vitamin B12 if deficient or vegetarian

• Thyroid function when indicated

Read more: Men Account For Nearly 3 Out Of 4 Suicides In India — Are We Ignoring A Growing Men's Mental Health Crisis?

Avoiding Smoking And Drinking Alcohol

Bryan avoids alcohol and tobacco completely. Research consistently suggests that avoiding smoking and limiting alcohol significantly reduce risks of cancer, liver disease, heart disease, stroke and other chronic lifestyle disorders.

Which Parts Of Bryan Johnson's Routine Are Controversial?

• Hundreds of daily supplements

• Intensive biomarker testing far beyond routine medical recommendations

• Experimental anti-ageing therapies

• Frequent advanced imaging

• Highly personalised protocols based on proprietary algorithms

Many of these approaches have not been proven to extend lifespan in humans, and experts caution against assuming that more testing or consuming supplements automatically leads to better health.

Every year on July 6, we mark World Zoonoses Day. The date marks the day in 1885 when Louis Pasteur gave the first rabies vaccine. It falls right in the middle of our monsoon, which is exactly when zoonotic diseases claim the most lives. So this year, instead of a routine health advisory, let us go through the questions I get asked most often, by patients, by family, and honestly, by fellow doctors too.

Q: What Is A Zoonotic Disease?

A zoonosis is any disease that spreads from animals to humans. The animal could be a rat, a dog, a bat, or even livestock in your backyard. Sometimes the animal itself looks perfectly healthy while carrying the germ that makes us sick. About six out of every ten infectious diseases known to affect humans started in animals at some point. COVID reminded the whole world of this. We have been living with zoonotic threats for years, quietly, every rainy season.

Q: Which Zoonotic Diseases Does India deal with most commonly?

If I had to list the usual suspects, it would be this:

• Leptospirosis
• Scrub typhus
• Nipah virus, linked to fruit bats, with Kerala's Kozhikode and Malappuram having seen outbreaks in past years
• Rabies from animal bites, mainly dogs and cats, and occasionally other animals

Q: So Which Of These Actually Rise During The Monsoon, And Why?

Leptospirosis is the one that rises sharply and predictably every single monsoon. The bacteria live in the kidneys of rats and other rodents and are released into soil and water through their urine. When the rains come, our fields, drains, and waterlogged roads become the perfect place for the infection to spread. Anyone walking barefoot through flood water, working in paddy fields, or wading through stagnant water near their home is at risk.

Scrub typhus rises a little later, once the rain eases and people go back into overgrown fields and gardens to clear vegetation, exposing themselves to the mite larvae hiding there. Our own data from KIMSHEALTH, based on 241 patients over seven years, shows this pattern clearly. Cases start climbing in September, peak in December, and drop off by January.

This means the disease follows the cool, humid weeks right after the monsoon leaves, not the rainy months themselves. Low temperature and high humidity suit the mites best, which is why the weeks just after the monsoon, not the heavy rain itself, are scrub typhus season. Our data also showed a smaller rise between June and August, so the risk is actually spread across two windows around the monsoon, not just one.

This year, our own health department figures have already shown this pattern. Fever clinics across the state have been seeing well over 10,000 patients a day at the peak, with leptospirosis and Shigella infections climbing sharply. Northern districts of Kerala Kannur, Kozhikode, and Malappuram have reported some of the sharper spikes, and rat fever sadly remains the biggest killer among these in most years.

Q: What about Nipah?

Nipah is not strictly a monsoon disease. It tends to appear when fruit bats are under stress, often during their breeding season or when their natural food is disrupted. Kerala has had confirmed cases in recent years. The good news is that Kerala now has one of the fastest outbreak response systems in the country for Nipah, with quick contact tracing and isolation.

Q: What can we do to protect ourselves?

For leptospirosis:

• Avoid walking barefoot through flood water or muddy fields, especially if you have any cuts or wounds on your feet
• Wash your legs and feet well with soap after any contact with flood water or waterlogged areas
• If you must work in fields or clean drains during the monsoon, wear boots and gloves
• Doxycycline tablets taken as prevention work well for people at high risk, such as farmers, sanitation workers, and flood relief volunteers. Please take this only on your doctor's advice, at the right dose and timing
• Keep the rat population around your home and workplace under control. This sounds like a small thing, but it matters more than any tablet

For scrub typhus:

• Avoid sitting directly on grass or vegetation when you go out for farm work or a walk in overgrown areas
• Wear long sleeves and full-length trousers when clearing bushes

For rabies:

• Any animal bite, however small it looks, needs immediate washing of the wound with soap and running water for at least fifteen minutes, followed by a visit to a doctor for vaccination
• Do not wait to see if the animal "seems fine." Rabies is fatal once symptoms begin, with no exceptions
• Get your own pets vaccinated regularly. This protects your family as much as your animal

Q: When Should Someone Actually Go See A Doctor?

See a doctor without delay if you have a fever along with any of the following:

• Fever lasting more than two days, especially if you have had recent contact with flood water, muddy fields, or rodents
• Severe muscle pain, especially in the calves, along with fever
• Yellowish color in the eyes or skin
• Passing less urine than usual
• Bleeding from gums, nose, or skin rashes with fever
• Severe body ache
• Breathlessness or confusion along with fever
• Any animal bite, no matter how small it seems

Leptospirosis in particular can look just like an ordinary viral fever in its first two or three days, and then get worse quickly, leading to kidney failure or bleeding problems. Starting antibiotics early makes a big difference to the outcome. This is not a disease where it is safe to simply wait and watch.