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

People who are prescribed blood thinners, also known as anticoagulants, could unknowingly weaken the effect of their medication by eating a widely consumed and otherwise healthy vegetable, a doctor has warned.

What Are Anticoagulants?

Anticoagulants are routinely given to reduce the risk of blood clots and are often prescribed to those who face a higher chance of such complications. This group also includes people at increased risk of heart attacks or strokes. These medicines, which include rivaroxaban, apixaban and warfarin, work by interrupting the clotting process and play a key role in preventing serious conditions such as strokes, heart attacks, pulmonary embolism and deep vein thrombosis.

Warfarin: Why This Common Vegetable Can Be A Problem

While anticoagulants are effective and often lifesaving, patients are being advised that a familiar garden vegetable could interfere with how well these drugs work. The warning comes from Dr Chris Steele, who appeared on ITV’s This Morning to explain how certain foods can interact negatively with different medications.

As part of his advice, he said, as per Express, “Leafy greens are high in vitamin K, which helps blood to clot. Warfarin works by blocking vitamin K production, so if you suddenly increase how many greens you eat, it can affect how the medicine works.”

He added: “Other foods that contain a lot of vitamin K include green vegetables, egg yolks, chickpeas and lentils. These foods don’t need to be removed from the diet, but it is important to keep your intake steady and consistent. You should also avoid drinking large amounts of cranberry juice or using cranberry products while on anticoagulants, as they can alter the effect of warfarin. Garlic and ginger should be limited too, as they can raise the risk of bleeding.”

Warfarin: Other Food And Drug Interactions To Watch For

Dr Chris also highlighted that many other medicines can react in unexpected ways when taken alongside certain foods and drinks. For example, he noted that some antibiotics, including ciprofloxacin, can react poorly with milk.

He explained: “Calcium can reduce how well some antibiotics work, so these medicines should not be taken at the same time as foods high in calcium, such as milk, yoghurt or cheese. Calcium supplements should also be avoided for a few hours before and after taking these antibiotics.

“You should not drink milk when taking certain antibiotics, including tetracycline and ciprofloxacin, which are quinolone antibiotics, or some osteoporosis drugs like alendronate, also known as Fosamax.”

He further advised avoiding the following combinations with specific medicines:

• Grapefruit if you are taking statins for high blood pressure
• Black liquorice if you are on certain heart medicines such as digoxin
• Bananas if you take some ACE inhibitors for high blood pressure
• Coffee if you use bronchodilators for asthma
• Smoked salmon and salami if you are prescribed antidepressants
• Limes if you are taking cough medicine

Dr Chris stressed: “Always speak to your doctor about any precautions you should follow when starting a new medication. You may need to avoid certain foods, make changes to your lifestyle, or take other steps to prevent unwanted side effects.”

Dr Jitendra Singh, the Union Minister of State for Science & Technology, Earth Sciences and MoS PMO said that weight reducing or anti-obesity drugs must be used judiciously. Dr Singh himself is a noted diabetologist and professor of medicine. He noted that obesity is a complex, chronic and relapsing disorder, "not merely a cosmetic or lifestyle concern". He called for a "whole-of-society" approach to effectively combat this health challenge that India is facing.

His remarks on obesity and usage of weight loss drugs were made at the inaugural session of the 2-day Asia Oceania Conference on Obesity. He pointed out that obesity cannot be treated with shortcuts, as it is a chronic disease.

India and Obesity

India is facing a severe and rapidly growing obesity epidemic, and it has become a major global hotspot with rising numbers of obesity patients across all ages, especially in the urban areas, noted UNICEF-organized national media roundtable. This is due to the increase in sedentary lifestyles, and processed foods. According to UNICEF’s Child Nutrition Global Report 2025, launched recently, obesity has, for the first time, surpassed underweight globally as the most common form of Malnutrition among school-aged children and adolescents. So is the case in India.

Dr Singh highlighted that India is witnessing a worrying rise in Non-communicable diseases or NCDs, which are also linked to obesity in a way. This has accounted for nearly 63 per cent of overall mortality. He also said that conditions like type 2 diabetes, cardiovascular diseases and certain cancers are linked to obesity, including central visceral obesity, which he says is "particularly prevalent among Indians and poses independent health risks even beyond overall body weight".

What Does The Data Say On Obesity In India?

The National Family Health Survey (NFHS) data shows that India is witnessing a rapid surge in overweight and obesity among children under five, with prevalence rising by 127 per cent, which has increased from 1.5 per cent to 3.4 per cent between NFHS 3 (2005-06) and NFHS 5 (2019-21).

Similarly, overweight and obesity rates among adolescents have risen sharply, increasing by 125 per cent in girls (from 2.4 per cent to 5.4 per cent) and a staggering 288 per cent in boys (from 1.7 per cent to 6.6 per cent).

Among adults, prevalence climbed by 91 per cent in women (from 12.6 per cent to 24.0 per cent) and 146 per cent in men (from 9.3 per cent to 22.9 per cent), underscoring a nationwide health crisis (NFHS-5, 2019–21).

By 2030, India is projected to have over 27 million children and adolescents aged 5 to 19 living with obesity, accounting for 11 per cent of the global burden (CNNS 2016–18).

What Is India Doing To Combat Rise In Obesity?

Dr Singh highlighted that under the leadership of Prime Minister Narendra Modi, India has taken steps to make health a priority. PM Modi's emphasis on small, sustainable changes in food habits and daily routines reflects a clear recognition of obesity as a national priority, closely aligned with initiatives like FIT India, Khelo India, and other versions of preventive healthcare. He also noted that Ayushman Bharat, mass screening programmes, and many health care initiative, along with integrating traditional system of medicine has also helped India to curb its obesity problems down.

Dr Singh also emphasized on the need of public awareness, especially in food habits like adoption of refined oils, or myths and disinformation that surround such health condition. To combat this, he launched the AIAARO ( All-India Association for Advancing Research in Obesity) Obesity Registry, a significant initiative aimed at strengthening India’s obesity research ecosystem through systematic data collection, evidence-based insights, and long-term policy support.

For a long time, screens have taken most of the blame for declining eyesight among children. Doctors, however, are now drawing attention to another factor that often goes unnoticed: polluted city air.

Delhi continues to struggle with severe smog. On December 23, 2025, residents woke up to a thick blanket of haze as air quality worsened sharply across the capital. At 8 am, the average Air Quality Index stood at 414, placing it in the ‘severe’ category, according to data from the Central Pollution Control Board (CPCB). While toxic air is known to harm the lungs, skin, and heart, eye specialists are now observing a worrying trend. Children are developing myopia, or near-sightedness, at much younger ages, and the condition appears to be progressing faster than before.

As India faces some of the highest pollution levels in the world, new research is shedding light on how fine particulate matter, limited exposure to natural daylight, and ongoing eye irritation may be affecting the visual health of children growing up in urban areas. To understand this better, we spoke to Dr Rishi Raj Borah, Country Director, Orbis (India), who explained how air pollution may be playing a role.

Is Smog Affecting Children’s Vision?

Healthy eye development during childhood relies heavily on regular exposure to bright outdoor light. This light helps regulate dopamine release in the retina, which plays a key role in preventing the eyeball from growing longer than normal, a defining feature of myopia. Multiple studies have shown that children who spend more time outdoors are less likely to develop near-sightedness.

Although excessive screen use remains a concern, polluted air is now being recognised as an added risk. High smog levels can lead to:

• Eye irritation and redness
• Dry eyes and allergic inflammation
• Discomfort that discourages outdoor play

Explaining the connection, Dr Rishi Raj said, “With rising air pollution and high concentrations of PM2.5 in the environment, children may spend less time playing outside and more time on screens. Exposure to polluted air can also trigger inflammatory changes on the eye surface, reducing comfort and causing strain or irritation, especially in children.”

What Is Myopia?

Myopia, commonly known as near-sightedness, is a vision condition in which distant objects appear blurred because light entering the eye focuses in front of the retina instead of directly on it. This usually happens when the eyeball grows longer than normal. While close objects remain clear, far-off objects become difficult to see. Myopia often develops during childhood or adolescence and is typically managed with glasses, contact lenses, or, in some cases, surgery, according to the Cleveland Clinic.

How Is Smog Leading To Myopia In Children?

Smog may contribute to the development and progression of myopia by causing inflammation and oxidative stress within the eyes. This can damage ocular tissues, thin the sclera, and encourage axial elongation of the eyeball. Pollutants such as PM2.5 and nitrogen oxides (NOx) are small enough to affect eye tissues, triggering inflammatory responses and activating enzymes that break down collagen. Research cited on ScienceDirect.com also suggests these pollutants may interfere with dopamine pathways that help regulate eye growth, further speeding up myopia progression.

Highlighting the long-term risks, Dr Rishi Raj said, “When myopia starts at a very young age, it tends to worsen more rapidly over time. As vision continues to decline, the risk of serious eye conditions later in life, including retinal detachment, glaucoma, and myopic maculopathy, increases significantly. Early detection and timely management are therefore extremely important.”

How To Protect Children From Myopia?

Dr Rishi Raj suggests several practical measures parents can take to support their children’s eye health:

• Follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for 20 seconds.
• Reduce recreational screen time and encourage frequent breaks.
• Make sure children get at least one to two hours of outdoor play each day, when air quality allows.
• Arrange regular eye check-ups, even if there are no obvious vision complaints.
• Ensure proper lighting and good posture during reading and screen use.

Doctors caution that if air quality continues to worsen and outdoor time keeps shrinking, India may see a sharp rise in childhood vision problems in the years ahead. While parents cannot fix pollution on their own, adopting healthier daily habits, staying alert to early signs of vision changes, and creating safer indoor environments can still go a long way in protecting a child’s eyesight in today’s polluted cities.