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

If you regularly drink your tea or coffee “very hot,” you may be at three times higher risk of developing a type of esophageal cancer, according to a new study.

The team found that drinking hot beverages at very high temperatures may increase the risk of esophageal squamous cell carcinoma (SCC), which forms in the mucosal lining of the food pipe.

Very Hot Drinks Linked To Higher Cancer Risk

Studies in Asia, Africa, South America and the Middle East have consistently shown that drinking tea or mate (a herbal drink) at very high temperatures (around 70°C) increases esophageal cancer risk. However, evidence has been limited for drink temperatures typically consumed in Western populations.

To explore this, a team at Oxford analyzed data from around 980,000 UK adults and tracked their health records for more than 10 years to see whether they developed esophageal SCC.

Also read: Why You Suddenly Can’t Tolerate Foods You Once Ate Easily

Compared with people who reported drinking their beverages “warm,” those who preferred their drinks “hot” had nearly twice the risk of esophageal SCC, while those who drank them “very hot” had a three times higher risk.

The findings “add to existing evidence that drinking very hot drinks could increase the risk of esophageal squamous cell carcinoma,” said Dr Keren Papier, lead researcher and senior nutritional epidemiologist at Oxford Population Health.

It’s The Temperature, Not Tea Or Coffee

But does the beverage matter? No, the study did not find that consuming tea and coffee increased the risk of esophageal SCC. Instead, the risk was associated with the temperature of any hot beverage consumed.

“Our findings suggest that reducing drink temperature in populations where tea and coffee are frequently consumed could offer an important means of SCC prevention,” the researchers said.

How Could Very Hot Drinks Raise Cancer Risk?

It is unclear how higher drink temperatures may affect esophageal cancer risk. However, existing evidence suggests that very hot drinks may damage the lining of the esophagus, which, over time, can increase the chance of cancer.

The International Agency for Research on Cancer (IARC) also classifies drinking very hot beverages above 65°C as “probably carcinogenic” to people.

What Is Esophageal Cancer?

Read More: Attention Ladies: More Than 5 Cups Of Coffee Linked To Lower Bone Density; Tea May Help

The esophagus is a long, hollow tube that helps move swallowed food from the back of the throat to the stomach for digestion. Esophageal cancer is a malignant tumor in the food pipe and primarily affects people over the age of 55.

Lifestyle factors that may predispose a person to esophageal cancer include tobacco use, alcohol consumption, chronic acid reflux, obesity, and poor diet choices.

In the UK, there is a 1% lifetime risk of being diagnosed with esophageal SCC.

How Can You Reduce Your Risk?

While the evidence linking hot drinks to cancer risk is still evolving, there are proven ways to reduce the risk of esophageal SCC.

“The most important ways to reduce the risk of this cancer type are not smoking and cutting down on alcohol,” said Fiona Osgun, head of health information at Cancer Research UK. Letting your tea or coffee to cool down a little before taking a sip, may be a good idea.

An eclectic approach combines therapeutic frameworks according to an individual's symptoms, personality, developmental history, cultural and socioeconomic context, coping patterns and readiness for change—while keeping the therapeutic relationship and client participation central to recovery.

Psychological difficulties rarely exist in isolation. Anxiety, depression, relationship difficulties or trauma-related symptoms may be influenced by cognitive patterns, emotional regulation, personality, developmental experiences, relationships and social circumstances.

This is why psychotherapy cannot always follow a single therapeutic model. Eclectic therapy allows clinicians to draw from established approaches such as CBT, psychodynamic therapy, trauma-informed interventions, attachment-based approaches, emotion-focused work, mindfulness and behavioural strategies, based on the individual's clinical needs.

Importantly, eclectic therapy is not an arbitrary combination of techniques. Each intervention should have a clinical rationale and be linked to the individual's psychological formulation.

Treatment begins with understanding the individual

A clinical formulation considers more than symptoms or diagnosis. Personality factors, developmental history, attachment patterns, family dynamics, cultural expectations, socioeconomic circumstances and social identities may all influence how psychological distress develops and is maintained.

For example, the same anxiety symptoms may reflect perfectionism and conditional self-worth in one person, while being associated with attachment insecurity or previous adverse experiences in another.

Therapeutic readiness is also important. A client experiencing significant trauma-related dysregulation may initially require safety, stabilisation, psychoeducation and emotional regulation before deeper trauma processing is appropriate.

Also read: Teachers' Day 2026: How Teachers Shape Students’ Mental Health

Previous coping attempts are clinically relevant

People often arrive in therapy after already trying to manage their difficulties through self-help, lifestyle changes, support from family or friends, boundary-setting or previous therapy.

These efforts should not be dismissed simply because they were unsuccessful. Understanding what the person tried, what helped, what did not and why provides valuable information for case formulation and treatment planning.

Coping mechanisms such as avoidance, perfectionism, emotional suppression or reassurance-seeking may also have served a protective function at an earlier stage. Therapy therefore focuses not merely on labelling a behaviour as maladaptive, but on understanding its function and developing more adaptive alternatives.

Also read: Mental Health Emergency Visits Among Children Aged 6-9 Rise 62% In England

How eclectic therapy may look in practice

Relationship difficulties: A client who becomes highly distressed by emotional distance in relationships may require a combination of attachment-based psychoeducation, emotion-regulation strategies, cognitive and behavioural interventions, alongside exploration of earlier relational experiences.

Emotional disconnection: A high-functioning client who feels emotionally numb may require less emphasis on problem-solving and greater focus on emotional awareness, intellectualisation, experiential work and exploration of how emotions have historically been managed.

Cultural and social context: Anxiety or depression in a client navigating family expectations, sexuality, gender, financial pressures or minority stress cannot always be understood solely through individual psychological processes. Cognitive, emotional, relational and contextual factors may need to be addressed together.

Therapy is a collaborative process

The therapist provides clinical expertise, psychological formulation, therapeutic skills and appropriate challenge, but the client remains an active participant in the therapeutic process and recovery.

This may involve reflecting on patterns, practising skills between sessions, experimenting with new behaviours and communicating openly about what is or is not working. This responsibility should not be confused with blame; therapy is a collaborative process in which the therapist provides guidance while the client gradually develops greater agency in managing their psychological wellbeing.

The therapeutic relationship remains central. Respect, psychological safety and appropriate therapeutic challenge are particularly important in trauma-informed practice. Respecting a client's history does not mean agreeing with every decision; it means understanding the experiences and circumstances within which those decisions were made.

Eclectic therapy recognises that psychological difficulties are multidimensional and that individuals differ in their personality, history, circumstances, coping mechanisms and capacity for change.

The central clinical question is therefore not simply which therapy works? but which therapeutic approach is most appropriate for this individual, for this difficulty, at this stage of treatment?

When grounded in clinical formulation and evidence-informed practice, eclectic therapy provides flexibility without losing therapeutic structure—allowing treatment to address the person rather than simply the presenting symptom.

Recent reports of more than 7,000 people aged 18 to 25 testing HIV positive in Karnataka have put the spotlight on HIV among India's younger population.

The development has prompted the Karnataka government to expand HIV awareness, counselling, and voluntary testing initiatives across colleges. But the numbers raise a bigger question: are young people actually seeing higher HIV transmission, or are more infections simply being detected?

In an exclusive conversation with HealthandMe, Dr. Ishwar Gilada, President Emeritus, AIDS Society of India and a globally acclaimed HIV/STI/infectious diseases expert, sheds light on the recent trends and patterns of HIV cases in India in the last few years. He also explained the shifting nature of HIV awareness, sexual behaviour, testing and prevention in India.

Factors Driving HIV Risk Among Young Population

1. The Cohort Effect

According to the doctor, India's HIV epidemic initially showed a steady increase after the first cases were identified in 1986 until at least 2005. He said cases were static from 2005 to 2010 and even started going down till 2020. He said that we started seeing an increase again in the last five to six years.

The doctor attributed the sudden increase in cases to what he described as a “cohort effect” which is affecting people born around or after 2000.

He explains, "Cohort affects those who are born, whom we call millennium babies, who are born either in 2000 or after that. Millennium babies, who are now 20-25 are more vulnerable."

2. Lack of HIV Awareness Campaigns

The doctor believes another reason could be that young people today were not exposed to the intensive HIV awareness campaigns that existed during the early 2000s.

He says, “They are vulnerable because high-profile campaigns for HIV awareness were there from around 2000 to 2005. After that, they stopped as improved HIV treatment started.”

Also read: Thailand’s HIV Cases Cross 550,000 In 2026; Over 25,000 Among 15–24s

3. Changing Sexual Behaviour

The doctor said another important factor is the changing nature of sexual relationships and how people perceive risk.

“Earlier it was believed that if you frequent red light areas, you may pick up HIV from sex workers. But young people say that we don't go to red light areas.”

According to the doctor, this perception can be misleading because sexual contact can occur in many different settings like massage parlours where one may also have access to services related to sex work.

He also pointed towards sexual relationships involving multiple partners. He says that there is a lot of interpersonal sexual contact happening and without any commitment with unknown partners. He says, "They do not consider them either self or that person at risk.”

He also highlighted HIV risk among homosexual men. He says, "After Section 377 has been repealed, same sex among has become more frequent. They do not consider themselves to be at high risk because they think that they are not having sex with the female or a sex worker.”

4. PrEP And PEP Awareness Are Misunderstood

The doctor also raised an interesting concern about growing awareness of HIV prevention medicines like PrEP and PEP.

“There is awareness about PEP, post-exposure prophylaxis, and pre-exposure prophylaxis. So what they started thinking even if we take a risk, there is a PEP available. If we have to take a risk, we can take a PrEP and we can have a medicine and then we can have sex.”

He also said people may selectively use prevention based on how risky they believe another person appears. The result, he said, is a potentially dangerous mismatch between perceived risk and actual risk.

5. Stigma May Stop People From Testing And Taking Treatment

The fear of being identified as someone living with HIV can become a barrier to diagnosis and treatment. For younger people, the problem can be even more difficult because they may live with their families and have little privacy. The doctor said society needs to recognise that HIV is now a manageable infection.

“Society has to accept that this is now infection, manageable, better than diabetes, better than many other diseases.”

He also argued that stigma is not confined to the public. “We have to blame medical community.”

He alleged that in healthcare, patients continue to get treated differently. He recalled a case involving one of his patients who was hospitalised.

He says, “One of my patients told me they wrote they had written HIV positive on my bed when I was hospitalised. So, if this is the way you are discriminating, that person won't be maintaining his anonymity of HIV that he did for 25 years.”

Also read: Tivicay: US FDA Approves Drug to Treat HIV In Newborns

How To Prevent HIV Transmission?

1. HIV Self-Testing Should Be Improved

The doctor identified HIV self-testing as one area where he believes India's programme could be strengthened. He says, “One of the flaws of the national program is home HIV testing kit is not allowed in the program. Though you can buy the home testing kit on Amazon,it is not available in the program. So marginalised people will not get tested.”

He also raised concerns about the price of commercially available kits. He says kits that cost Rs 700 to 800 must not priced more than Rs 100 to 200.

2. Limited Access To PrEP

PrEP, or pre-exposure prophylaxis, was another area the doctor believes requires greater attention. “PrEP is not part of the national program,” he said, adding that PrEP has been approved in India but is not sufficiently integrated into the public programme. He said if this is fixed, people who are not aware of their HIV status will also try to find out.

3. HIV Stigma Remains A Major Problem

One of the strongest messages the doctor gives is how HIV treatment has changed dramatically, but it is still stigmastised. He explained that treatment can also suppress the virus to the point where sexual transmission does not occur.

He says, “HIV treatment is so powerful that a person with HIV can stay alive for as much as the normal lifespan of any person in the.” But while treatment has transformed HIV medically, the doctor said society has not kept pace. “Currently, the major killer, if at all, we can call, is the stigma and discrimination.”

Also read: Unlicensed Injection Business Sparks Health Alert In Canada: How HIV & Hepatitis Spread Through Medical Procedures

4. People Should Not Wait For Symptoms

Another important point the doctor stressed is that HIV can remain clinically silent for years. But as the immune system becomes progressively weakened, the person becomes vulnerable to infections that would ordinarily be easier for the body to fight.

“Talking about symptoms, when virus multiplies initially, the person will have no symptoms. It takes two to four years, five or even 10 years' time. If you wait till you fall sick, then a lot of valuable time will pass.”

His message was therefore to test and start treatment before advanced immune damage occurs.

5. Prevention Should Go Beyond Awareness

When asked about prevention, the doctor divided it into pharmacological and non-pharmacological approaches. He emphasised upon safe sex and reducing exposure to multiple sexual partners.

The larger lesson from his interview is that HIV prevention cannot depend on a single intervention. It requires testing, treatment, condoms, PrEP and PEP where appropriate, harm-reduction measures, awareness and, perhaps most importantly, an environment where people are not afraid to seek care.

The Bigger HIV Challenge

India has made significant progress against HIV over the past several decades. The government has reported substantial reductions in new HIV infections since 2010, while the National AIDS Control Programme continues to focus on prevention, testing, treatment and reducing AIDS-related mortality.

But the Karnataka numbers have brought the concern of young people's vulnerability to infection. The biggest challenge is no longer simply whether HIV can be treated. It is whether people will get tested early enough, have access to prevention and treatment, continue taking their medicines, and be able to live without fear of being discriminated against.