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

We often hear of dementia as an adult, or older people's disease, but, a father from Glasgow shares how his four-year-old daughter was diagnosed with the condition. Childhood Dementia news of Darren Scott's daughter was delivered to him like a "complete thunderbolt", he tells Sky News. She was diagnosed with the condition before she turned four. Five doctors were waiting, when Sophia Scott, who had just turned four, were summoned to a Glasgow hospital room. Then came the worst news. Scott was told that his daughter could not live beyond the age of 16. "We were told... there was nothing they could do. It was a moment that broke us, shattered our lives. We have never recovered," he says.

What Is Childhood Dementia?

As per Dementia Australia, childhood dementia is a rare brain condition that affects one in every 2,900 babies globally. Childhood dementia is a group of serious brain conditions that interfere with a child’s memory, behavior, emotions and ability to communicate. It isn’t caused by lifestyle or ageing. Instead, it stems from more than 100 rare genetic disorders that children are born with. These include conditions such as Niemann-Pick type C, Batten disease and Sanfilippo syndrome.

No two children experience childhood dementia in the same way. The illness progresses differently for each child, but one thing remains constant: there is currently no cure. Like adult dementia, childhood dementia is progressive, meaning symptoms worsen over time. Heartbreakingly, around half of all affected children do not survive beyond the age of 10.

What causes childhood dementia?

Childhood dementia is genetic. Globally, about one in every 2,900 babies is born with a condition that can lead to childhood dementia. In Australia alone, an estimated 1,394 children were living with dementia in 2021.

The conditions that cause childhood dementia fall into several categories, including inborn errors of metabolism, lysosomal disorders, mitochondrial disorders, mucopolysaccharidoses, leukodystrophy, neurodegeneration with brain iron accumulation (NBIA), and peroxisomal diseases.

Signs and symptoms to look out for

Symptoms can begin in early childhood or appear much later, sometimes not showing up until the teenage years. The progression may be rapid or unfold slowly over several years, deeply affecting both the child and their family.

Much like adults with dementia, children may struggle with memory loss, confusion, changes in personality, anxiety or fear, and severe sleep disturbances. They may also find it difficult to concentrate, learn, communicate or understand things, and some experience behavioral challenges such as hyperactivity.

In addition, childhood dementia can affect the body beyond the brain. Children may develop problems with their bones or joints, experience issues with the heart, lungs or digestive system, lose their ability to move, see or hear, or have seizures.

As the condition advances, children gradually lose skills they once had — talking, walking, reading, writing and playing. Eventually, the body itself begins to shut down. Without major medical breakthroughs and more research, most children with childhood dementia will continue to face a shortened life, often not surviving beyond their teenage years.

India is staring at a sharp rise in lung cancer cases over the next few years, with experts warning that the disease is no longer confined to smokers alone. A recent study published in the Indian Journal of Medical Research projects a significant increase in lung cancer incidence by 2030, with certain regions, particularly the North-East, expected to bear a disproportionate burden. Alarmingly, women are showing one of the fastest rises in new cases.

At a time when the country is on the brink of what researchers describe as a “tsunami” of lung cancer cases, doctors stress that public awareness, early detection, and breaking long-held myths are more important than ever.

Lung Cancer Is No Longer Just a Smoker’s Disease

Lung cancer has long been associated almost exclusively with smoking, but experts say that narrative is outdated. Speaking to The Times of India (TOI), Dr Arun Kumar Goel, Chairman – Surgical Oncology at Andromeda Cancer Hospital, Sonipat, explained that while smoking remains the biggest risk factor, non-smokers are increasingly being diagnosed with the disease.

“Air pollution, indoor cooking smoke, passive smoking, radon gas exposure, occupational hazards like asbestos, and even family history can contribute to lung cancer,” Dr Goel explined. He added that adenocarcinoma, a subtype of lung cancer, is particularly common among non-smokers and appears to be linked more to environmental and genetic factors than tobacco use.

Early Symptoms Are Easy to Miss

One of the biggest challenges with lung cancer is that its early symptoms are often vague and easily mistaken for common respiratory problems. Dr Goel told TOI that persistent cough, changes in cough pattern, coughing up blood or mucus, unexplained chest pain, breathlessness, fatigue, and sudden weight loss are warning signs that should not be ignored.

“In India, lung cancer symptoms often overlap with illnesses like tuberculosis, which leads to delays in diagnosis,” he said. As a result, many patients only seek medical help when the disease has already progressed to an advanced stage.

What a Diagnosis Changes Overnight

A lung cancer diagnosis can be life-altering, both physically and emotionally. According to Dr Goel, patients are suddenly faced with difficult treatment decisions, ranging from surgery and chemotherapy to radiation or targeted therapy. Physical symptoms such as breathlessness and exhaustion can significantly affect daily life.

Emotionally, patients may experience shock, anxiety, fear about the future, concerns for their families, and a loss of independence. “Support from medical teams, counselling services, and loved ones plays a crucial role during this period,” he said.

The Biggest Myth That Delays Care

The most damaging myth, experts say, is the belief that lung cancer only affects smokers. Dr Goel warned that this misconception often results in non-smokers dismissing symptoms or doctors delaying screening. “Anyone can develop lung cancer, regardless of smoking history,” he said.

Early Detection Can Save Lives

If there is one message the public should remember, Dr Goel said, it is that early detection can dramatically improve outcomes. Persistent cough lasting several weeks, unexplained breathing difficulties, or ongoing chest discomfort should prompt immediate medical attention.

“Recognizing symptoms early and seeking help can change the course of treatment and significantly improve quality of life,” he said.

Face masks are not adequate when it comes to protection against flu-like illnesses, including COVID, said the World Health Organization (WHO) guidelines. As the number of flu cases rise in the US and the UK, this WHO guideline, may be of use. The guidelines noted that the surgical masks worn by doctors and nurses, when they are face to face with a patients are no longer providing the protection, and must be replaced with respirators.

The guidelines noted in a letter to the WHO chief Dr Tedros Adhanom Ghebreyesus, noted there is “no rational justification remaining for prioritizing or using” the surgical masks that are ubiquitous in hospitals and clinics globally, given their “inadequate protection against airborne pathogens”. “There is even less justification for allowing healthcare workers to wear no face covering at all,” the letter read.

When COVID was at its peak, an estimated of 129 billion disposable face masks were being used around the world every month. These were used by the healthcare workers as well as general public. These surgical masks were most widely available and recommended by most health authorities during that time. However, respirators were then designed to filter tiny particles. Then came the masks FFP2/3 standards in the UK or the N95 in the US. Evidence also supported that many countries are switching to these masks and that they are more effective. This resulted in fewer infections in patients and health professionals, as well as reducing the rate of sickness, and burnout of the healthcare professionals.

What Is The Key Difference Between Respirator and Surgical Mask?

Face masks are loose in fitting and are designed for one-way protection. It protects others from coughs and sneezes. WHO recommends a three-layer mask when people cannot socially distance. However, not all face masks have a safety rating.

The respirators on the other hand has a tight fitting, which creates a facial seal and filters both inflow and outflow of air. It tightly covers the nose and the mouth. It also removes 94% of all particles that are 0.3 microns in diameter or larger. It is also designed to protect the wear up to the safety rating of the mask.

COVID - Airborne or Not?

The WHO has faced criticism for its delayed acknowledgment of Covid-19’s airborne transmission. The letter urges the agency to reassess its earlier position and clearly communicate to the public that the virus spreads through airborne respiratory particles.

Professor Trisha Greenhalgh of the University of Oxford, a signatory to the letter whose research is widely cited in it, said that infection occurs only when germs enter the body. She explained that respirators, which seal tightly against the face, force air to pass through high-grade filters that block airborne pathogens. In contrast, she noted, medical masks fit loosely and allow significant air leakage.

Supporters of the letter include members of the World Health Network, leading US epidemiologist Eric Feigl-Ding, and Guardian columnist George Monbiot.

Responding to the letter, a WHO spokesperson said it would undergo “careful review.” The spokesperson added that the organization consults experts across diverse health and economic settings when developing guidance on personal protective equipment for healthcare workers, and that its Infection Prevention and Control guidelines for epidemic- and pandemic-prone respiratory infections are currently under review in light of the latest scientific evidence.