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

After the Thanksgiving, on Friday, the Food and Drug Administration (FDA)'s top vaccine regulator, Vinay Prasad made a clam that shocked the public-health established. "For the first time, the US FDA will acknowledge that COVID-19 vaccines have killed American children," he wrote in a leaked email to his staff, as reported by The Atlantic and The Washington Post.

The agency has identified that at least 10 children died after getting COVID shots.

The email has been perceived by physicians as a "threat". A response from 12 former FDA commissioners, published in The New England Journal of Medicine on Wednesday, called Prasad's memo "a threat to evidence-based vaccine policy and public health security". All of the potential vaccine related deaths reported to government were already reviewed by the agency's staff, and had reached "different conclusions", wrote the former commissioners.

Elsewhere, doctors and scientists have declared that there are no evidence that links COVID-19 vaccines to deaths in children. The commissioners have claimed that in an attempt to deliberately bring evidence, Prasad and his colleagues had engaged in an "evidence-manufacturing mission", a "dumpster dive" for shoddy data, or worse, a campaign of lying.

Prasad is one of several public health officials who, under Robert F. Kennedy Jr.’s leadership, have been steadily chipping away at public trust in vaccines. So far, he has not provided evidence to back his claims, and his estimate of vaccine-related deaths may be exaggerated. The memo’s intense language and focus on political complaints also cast doubt on his assertions.

However, something that cannot be ignored is that fact that his memo may have provoked people to deny even the possibility of COVID-vaccine-related deaths. The Atlantic notes that "the idea that mRNA-based shots have, tragically, killed a very small number of children is not far-fetched." The article written by Benjamin Mazer, a physician who specializes in pathology and laboratory, notes that the this does not imply a "catastrophic threat to public health" as tens of millions of doses of the same vaccines have saved young people.

Understanding the Debate Of Vaccine-Linked Deaths

Public-health experts agree that COVID vaccines, like all medical treatments, can cause side effects. Myocarditis, a rare heart inflammation seen mostly in adolescent boys and young men after mRNA shots, remains the most discussed risk. Although usually mild and far less severe than virus-induced myocarditis, a few deaths have been documented worldwide, including isolated cases in the U.S., South Korea, and two American teenagers described in a peer-reviewed report.

These findings fuel ongoing debate about whether extremely rare vaccine-related deaths are being overlooked. Some scientists, including Paul Offit and Michael Osterholm, say the evidence does not prove the vaccines caused these deaths, noting that population-level studies show no rise in mortality after vaccination. Others argue that well-investigated autopsy-confirmed cases should be taken seriously rather than dismissed outright.

Experts such as Krutika Kuppalli, as cited by Mazer, emphasize that even if deaths occur, they are so uncommon they do not appear statistically, while the benefits, significantly reduced COVID mortality, are unmistakable. However, individual cases still raise questions on health authorities and the stricter standards of proofs they have applied when vaccines were involved to create a room for skepticism.

The concern is that rare side effects of vaccines could go undiscovered and not that vaccinations are inherently harmful.

Are you down with fever? Are your symptoms also a little less common from an ordinary cold? Are you also confused between flu and COVID? Then knowing this one symptom could help you set flu apart from COVID. Dr Rupa Parmar, a GP and medical director at Midland Health tells The Mirror, that shortness of breath could be a key symptom that could differentiate between the two.

Dr Parmar highlights that it is a key indicator for COVID. "Shortness of breath is rare in both a cold and the flu, but as COVID more so affects the lungs due to inflammation, it is a common symptom."

The NHS website supports her advice, noting that breathlessness is a symptom more often tied to Covid, not the flu or a common cold. This kind of breathing difficulty is usually associated with infections like Covid or respiratory syncytial virus (RSV).

What Else Could Help You Know If You Have A COVID or Flu?

The nature of your cough could also help you understand different ailments. Dr Parmar said that a cold would produce a mild cough, whereas a flu cough could be more dry. However, with covid, "a cough will be dry and continuous, and many people will cough for more than an hour or have three or more coughing episodes within a day."

If one has lost their sense of smell or taste, then the chances are, this could be COVID. However, this symptom is also present in cold or in a flu.

For people who have Covid, the NHS advises staying home and avoiding contact with others if they or their children have symptoms and either develop a high temperature or feel too unwell to work, attend school, manage childcare, or carry out daily activities. If you are unsure about the cause, it is important to speak with a doctor.

Dr Parmar emphasized: "after all, it is always better to be safe than sorry when it comes to health."

What Is Flu?

The flu is a common respiratory illness that happen from the influenza virus. The common flu symptoms are:

• Fever
• Sore Throat
• Runny Nose
• Fatigue
• Body Aches
• Cough
• Headaches

What Is COVID-19?

As per the US Centers for Disease Control and Prevention (CDC), COVID-19 is a respiratory illness caused by the coronavirus. The common symptoms include:

• Fever
• Cough
• Fatigue
• Headache
• Nausea
• Sore Throat
• Runny Nose
• Loss of smell or taste

COVID-19 could also have some long-lasting symptoms unlike flu or cold, that could seem unrelated to the original infection.

As per the Ohio State University, the most recent COVID variant is XFG or the Stratus variant. Another new variant that causes the 'razor blade' like sore throat is Nimbus.

The symptoms of this new variant includes:

• Congestion
• Cough
• Fever
• Headache
• Sore throat
• Muscle Aches

'Razor blade' Throat

NB.1.8.1 or the Nimbus variant is a subvariant of Omicron, which is a dominant COVID variant since late 2021. Omicron variants tend to cause more throat problems than the other variants seen earlier.

The COVID virus binds to ACE2 receptors. According to WebMD, the cells in your nose and throat contain more ACE2 receptors than those deeper in the lungs, which makes them easier targets for Omicron variants. Once the virus attaches to these receptors in the upper airway, your immune system begins to respond.

Ever since the Trump administration has come to power, sentiments against vaccines have gone up. Many vaccine critiques have been handpicked by the anti-vaxxer HHS Secretary RFK Jr. as health officials. So it is no surprise that now the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) is now recommending that mothers who test negative for hepatitis B should discuss the need for the vaccine with their doctors. If parents choose to delay the birth dose, the first shot should be given at no earlier than two months of age. This is dropping the longstanding hepatitis B vaccine guideline that stated that every newborn receive the first dose of the hepatitis B vaccine shortly after birth. This recommendation, in place since 1991, was reversed on December 5 after a key CDC advisory committee voted to change the policy.

This committee was appointed by Health and Human Services Secretary Robert F. Kennedy Jr., who dismissed all 17 previous members earlier this year. The shift in policy has triggered wide debate, especially in the medical community, because it overturns one of the longest standing infant vaccination guidelines in the United States.

Below are some of the claims made by the panel, both sides, who debated the vaccine's need or unimportance for all infants.

Hidden Hepatitis B Infections Make Risk Hard to Judge

Claim: Several ACIP members questioned whether babies considered “low risk” truly need a hepatitis B shot at birth. But hepatitis B is not always easy to detect or trace.

The virus spreads through bodily fluids such as blood, semen and vaginal fluids. It is also extremely resilient and can survive on surfaces for up to a week. Even tiny amounts of dried blood from everyday items like razors, toothbrushes or nail clippers can carry the virus.

Hepatitis B often has no symptoms for years. The CDC estimates that 640,000 adults in the United States live with chronic hepatitis B, and half do not know they are infected. This means that even if a mother tests negative during pregnancy, her newborn can still be exposed through family members or other caretakers. Before universal birth-dose vaccination began, only half of infected children under age ten had contracted the virus from their mothers at birth.

Because so many people are unaware of their infections, determining true risk is complicated.

The Vaccine Protects the Most Vulnerable: Newborns

Claim: Some committee members suggested that vaccinating all newborns mainly protects adults or others at higher risk.

That claim is misleading. The primary purpose of giving the shot at birth is to protect infants, who face the most severe long-term consequences of infection.

Hepatitis B attacks the liver. If an infant becomes infected, there is a very high chance the disease will progress into a chronic lifelong condition. About a quarter of those children eventually die prematurely from liver failure or liver cancer. While treatments exist to reduce complications, there is no cure.

Dr. James Campbell, a pediatric infectious disease specialist at the University of Maryland, reminded the committee that the vaccine strategy transformed public health outcomes. “We used to have 18,000 or 20,000 kids born with this every year, and a quarter of them would go on to develop liver cancer. We now have almost none,” he said.

Falling Infection Rates Show Vaccines Worked

Claim: Hepatitis B infections fell sharply after the birth-dose recommendation took effect. Before vaccination became routine, up to 300,000 Americans were infected annually. About 20,000 of those were children.

Today, total annual cases have dropped to around 14,000. Among people under 19, chronic infections have reached extremely low levels. In 2022, the CDC documented only 252 new cases in this age group.

ACIP member Dr. H. Cody Meissner, who voted against changing the policy, argued that declining numbers do not justify easing precautions. “It is a mistake to say that because we are not seeing much disease, we can change the schedule,” he said. “If we do, hepatitis B infections will come back.”

The United States Is Not an Outlier

Claim: Some committee members compared U.S. policy to countries such as Denmark, which does not vaccinate all newborns.

However, the United States is far from alone in recommending a universal birth-dose. According to CDC data from September 2025, 116 out of 194 World Health Organization member countries recommend hepatitis B vaccination at birth.

Denmark does not include hepatitis B in its standard childhood schedule, but it has a centralized national health system, higher prenatal screening rates and less fragmented medical records. The United States lacks these structural advantages, which makes relying solely on maternal testing more challenging.