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

Persistent back pain in young adults is often dismissed as poor posture, long hours at a desk, or muscle strain. But doctors are warning that in some cases, it could be a sign of ankylosing spondylitis — a chronic inflammatory autoimmune disease that affects the spine and can silently progress for years before diagnosis.

In India, 16.5 lakh people suffer from the condition, with an average diagnostic gap of nearly seven years from the time symptoms first appear. During that window, the disease continues to silently progress, and the burden is far from small.

“Ankylosing Spondylitis is one of the most underdiagnosed conditions we encounter in clinical practice, and the consequences of that delay are real,” Dr. Arvind Mehra, Senior Director and HOD - Orthopaedics at Paras Health Gurugram, told HealthandMe.

Moreover, “It takes several years of pain and stiffness before people seek treatment, and by then, the diagnosis comes too late, and there has already been damage to the spine,” added Dr. Ashish Tomar, Director - Orthopaedics & Minimally Invasive Spine Surgery at Sarvodaya Hospital, Faridabad.

What Is Ankylosing Spondylitis?

Ankylosing spondylitis, also known as axial spondyloarthritis, is a type of arthritis that primarily targets the spine but can also affect other joints. The term “ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” indicates inflammation.

The inflammatory disease causes some of the bones in the spine to fuse over time. This fusing not only makes the spine less flexible but can also cause issues while breathing.

Ankylosing spondylitis leads to inflammation in the spine and large joints, causing stiffness and pain. It can also impact the joint between the spine and the hipbone, potentially resulting in additional symptoms such as digestive issues, rashes, and weight loss.

Not Your Typical Back Pain

What makes ankylosing spondylitis difficult to spot is that it often feels like ordinary back pain — but there are warning signs that set it apart.

According to experts, ankylosing spondylitis-related pain typically:

• Causes maximum stiffness early in the morning
• Gets worse after long periods of rest
• Improves with physical activity or exercise
• Persists for months rather than days or weeks
• Often begins in young adults, especially in their 20s and 30s

This pattern is very different from mechanical back pain, which usually worsens with movement and improves with rest.

Pain Beyond The Spine

Dr. Tomar told HealthandMe that ankylosing spondylitis is not simply a musculoskeletal problem — it is an autoimmune disease, where the body’s immune system mistakenly attacks healthy tissues, particularly around the spine and joints.

“Ankylosing spondylitis is not just another musculoskeletal disease. It requires the attention given to autoimmune disorders because it may affect the chest, hips, shoulders, and even the eyes, while also causing severe posture problems in advanced stages,” he said.

Beyond the spine, the disease may affect:

• Chest joints
• Hip joints
• Shoulders
• Eyes
• Posture, causing severe problems in the advanced stages

Who Is At Most Risk? How To Treat?

Young adults, typically in their twenties, are more likely to experience this condition because people often overlook its existence or mistakenly identify it as something else.

The combination of early diagnosis, structured physiotherapy, and suitable medications allows for effective disease progression control.

“When a young adult presents with inflammatory back pain, especially in the gluteal area, that persists beyond three months, the reflex should not be to prescribe a painkiller and wait. It should be investigated further. That shift in approach can make an extraordinary difference to someone’s long-term quality of life,” Dr. Tomar said.

Common treatments for ankylosing spondylitis include:

• Regular physical activity can reduce stiffness and prevent worsening of ankylosing spondylitis
• Over-the-counter painkillers for pain and inflammation
• Biologic DMARDs to reduce inflammation and pain, potentially halting disease progression.
• Corticosteroids are prescription anti-inflammatory medications
• Surgery is rarely suggested for severe symptoms unresponsive to other treatments.

When women are in their 40s, their bodies start to change a lot because of the hormones. This is mainly because the estrogen and progesterone levels in the body start to go down. This time is called Perimenopause.

It is when women start to move towards menopause. It can bring a lot of emotional changes. Some of these changes are normal.

Why Do Hormonal Changes Happen After 40?

After 40, women's bodies start to produce estrogen. This means they can have an imbalance.

Women's bodies need hormones like estrogen and progesterone to have periods, strong bones, a good mood, and to stay at a healthy weight. When these hormone levels change, it affects parts of the body. This change can take a year before it stops at menopause.

Common hormonal changes women experience

• Irregular periods

• Hot flashes and night sweats

• Mood swings and anxiety

• Weight gain and slower metabolism

• Sleep disturbances

• Skin and hair changes

Symptoms That Should NOT Be Ignored

While some changes are normal, some symptoms need a doctor's help:

• Heavy or prolonged bleeding

• Persistent fatigue

• Severe mood changes

• Sudden weight gain

• Bone pain or weakness

When women are over 40 and their hormones change, they are more likely to have:

• Heart disease
• Osteoporosis
• Thyroid disorders
• Metabolic issues

Estrogen helps keep the heart and bones healthy, so when its levels go down, women are more likely to have these health problems."

How Can Women Manage These Changes?

• Eat a balanced diet

• Exercise regularly

• Manage stress

• Have regular health check-ups

• Sleep well

Women should talk about these changes openly. If they know what is happening and see a doctor early, they can make this time easier.

Hormonal changes after 40 are a part of getting older, but women should not ignore them. Especially if the symptoms are very bad or happen all the time.

If women understand what is happening in their bodies and see a doctor when they need to, they can be healthier and more confident. If women take care of themselves now, they can have a life in the years to come.

The US Food and Drug Administration (FDA) has approved tradipitant to be sold under the brand name Nereus, for the prevention of vomiting induced by motion in adults — a first in the last four decades.

Motion sickness affects an estimated 65 to 78 million Americans—roughly 25 to 30 percent of adults—during everyday travel by car, plane, or boat. For decades, patients have had no meaningful new treatment options.

Tradipitant is an oral neurokinin-1 (NK-1) receptor antagonist that prevents motion-induced vomiting in adults.

It is an oral capsule, often taken 60 minutes before travel to block signals causing nausea.

The drug by Vanda Pharmaceuticals is now commercially available across the US.

"Today marks an important milestone for the tens of millions of Americans who experience motion sickness symptoms during common travel," said Mihael H. Polymeropoulos, M.D, President, CEO, and Chairman of Vanda, in a statement.

How Tradipitant Prevents Motion Sickness?

Motion sickness occurs when the brain receives conflicting signals from the eyes, inner ear, and body while in motion. This sensory mismatch is believed to trigger the release of substance P, which activates NK-1 receptors in the central nervous system and ultimately leads to nausea and vomiting.

Tradipitant works by blocking these receptors, interrupting the vomiting pathway.

"NEREUS is a selective, high-affinity antagonist of human substance P/neurokinin-1 (NK-1) receptors that can block the vomiting center of the brain,” Polymeropoulos said.

Tradipitant was approved by the FDA, following two pivotal Phase 3 clinical trials—Motion Syros and Motion Serifos—conducted under real-world conditions on the open sea.

Also read: India Installs US FDA-approved Portable MRI For Bedside Brain Scans At AIIMS Delhi

Both studies demonstrated that tradipitant significantly prevents vomiting compared to placebo, confirming the drug's effectiveness in actual sea travel conditions. It is the first new prescription option for people with a history of motion sickness in over 40 years.

It employs a novel mechanism as a selective, high-affinity antagonist of human substance P/NK-1 receptors. It offers simple dosing with just one or two capsules a day taken approximately an hour before travel.

Is Tradipitant Safe? Are There Any Side-Effects?

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According to Vanda Pharmaceuticals, tradipitant may impair abilities required for driving a motor vehicle or operating heavy machinery.

Combining tradipitant with sedatives or medications that increase the drug's levels may increase this effect. If use together cannot be avoided, your doctor may warn against driving or operating heavy machinery.

The most common side effects associated with tradipitant include drowsiness, headache, and fatigue.

Moreover, strong CYP3A4 inhibitors may increase NEREUS™ levels and the risk of side effects, the company said.

There are limited data on tradipitant's use in pregnant women and children.

Tradipitant is also not recommended in patients with liver problems or severe kidney problems.