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

The brain is a crucial component of the human body. It is an integral part of the whole system, but when the body ages, the brain does too. The brain is the organ that plays a big role in the aging process. The brain protein is an important component of the body, and can positively impact inflammation, memory decline, and other age-related changes.

A recent study conducted by PLOS Biology claims that the brain protein Menin loss can be crucial to inflammation, memory decline, and other age-related changes. The researchers in the study used mice as test subjects and tried to restore the very protein in them, which worked marvelously; aging conditions were completely reversed.

The study found that aging can be highly influenced by the hypothalamus, a strong brain region that regulates metabolism, hormones, body temperature, sleep, and stress responses. According to the researchers, the hypothalamus is a central command centre for aging.

The research was done by Lige Leng and colleagues at Xiamen University in China and mainly focused on the Menin. They intended to see what the impact would be if someone lost this very important protective protein. The study on mice shows that when Menin levels drop in the hypothalamus, it causes faster aging.

The study specifically used young mice and reduced menin levels; as a result, they faced brain inflammation, thinning skin, lower bone mass, impaired balance, memory problems, and a shorter lifespan. Thus, the conclusion of the research was that menin is likely to act as an anti-aging component in the body.

How Much Protein Do You Really Need?

Your protein needs aren’t one-size-fits-all. They depend on several factors: your weight, age, physical activity, body composition goals, and overall health status.

The Recommended Dietary Allowance (RDA) for the average adult is 0.36 grams per pound (0.8 grams per kilogram) of body weight. This amount is to meet basic nutritional needs in most sedentary adults.

However, experts suggest that physically active people often need more, anywhere from 0.54 to 0.9 grams per pound (1.2–2 grams per kilogram) per day. Athletes may even require higher amounts to support muscle repair and performance.

Certain groups, such as pregnant or breastfeeding individuals, older adults, and people recovering from illness or injury, also have increased protein needs. For example, during pregnancy, the recommendation rises to about 0.5 grams per pound (1.1 grams per kilogram).

According to the World Health Organization (WHO), tobacco use kills over 8 million people globally each year, including non-smokers exposed to second-hand smoke.

India continues to face a massive burden of tobacco addiction. Cigarettes, bidis, gutka, pan masala and khaini continue to affect millions, including young adults. This year’s WHO theme- “Unmasking the Appeal: Countering Nicotine and Tobacco Addiction” focuses on how flavoured products, attractive packaging and social media marketing are making nicotine products appealing to the younger generation.

Tobacco damages nearly every organ in the body. It is strongly linked to cancers of the mouth, throat, voice box, lungs, food pipe and bladder. In India, oral cancer remains one of the commonest cancers, largely driven by smokeless tobacco use. Tobacco also increases the risk of heart attacks, strokes, chronic lung disease, infertility and poor immunity.

Many people mistakenly believe that e-cigarettes and vaping are “safe alternatives.” However, e-cigarettes still contain addictive nicotine and harmful chemicals that can damage the lungs and cardiovascular system. They may also act as a gateway to conventional tobacco use among teenagers and young adults. Recognising these risks, India banned the production, sale and advertisement of e-cigarettes under the Prohibition of Electronic Cigarettes Act, 2019.

The encouraging fact is that quitting works at any age. Within weeks of stopping tobacco, blood pressure and lung function begin to improve, while long-term risks of cancer and heart disease reduce significantly.

Simple Steps To Quit Tobacco

* Fix a quit date and inform family and friends.

* Identify triggers such as stress, tea, alcohol or social gatherings.

* Avoid keeping tobacco products nearby.

* Stay physically active and hydrated.

* Seek professional counselling if cravings are severe.

* Nicotine replacement therapy or prescribed medications may help selected individuals.

* Remember that relapses can happen and restarting the quit journey is still progress.

World No Tobacco Day is not just about awareness but is a call to action. Choosing to quit today may be the single most important decision for a healthier and longer life.

(Dr Akshat Malik, Senior Consultant, Head & Neck Oncology, Apollo Hospital, Delhi)

According to the Indian Council of Medical Research - National Cancer Registry Programme (ICMR-NCRP), India reports about 220,000 new cases every year, and the common treatment procedure for this disease is chemotherapy, which comes with profound fatigue, hair loss, nausea, compromised immunity, and nerve damage.

The University College London led the Optima trial, which studied over 4000 patients with the disease in different parts of the world, and a low score on the genomic test could be mediated with only hormone therapy.

The trial’s chief investigator and a professor of breast oncology at UCL, Professor Rob Stein, explains that the study used tumour biology to guide decisions instead of relying on traditional clinical procedures.

The research had 4,429 women participants above the age of 40 years with hormone-positive breast cancer. These patients were then divided into two groups based on the genomic test results by the researchers, and one group with a higher risk was given chemotherapy along with hormone therapy, while the others were only treated with hormone therapy.

What Is Breast Cancer?

Breast cancer refers to the uncontrolled growth of the cells that are found along the inner lining of breast tissue. This out-of-control growth of cells leads to the formation of tumours. The tumour can be “invasive”, meaning that it spreads to the nearby tissues outside the breast, or “in situ”, where the tumour does not spread outside the breast region.

Usually, the “in situ” type of tumour is non-cancerous and non-life-threatening. However, in the case of invasive tumours, the cancerous cell mass can spread to the lymph nodes and further metastasise, that is, spread to other body parts. About 80% times the breast cancer cases are invasive. Hence, upon noticing symptoms like lumps, changes in breast shape, or abnormal nipple discharge, you must promptly consult a doctor.

While both men and women can develop it, in 99% of cases of breast cancer, women are seen to be affected by it. Only 0.5 to 1% of men are affected due to this condition. Furthermore, the condition is mostly prevalent in women aged 50 or older.