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

In my 13 years of working with clients as a trauma-informed consulting psychologist, I have often noticed that people recognise nervous-system overload only after their body forces them to slow down.

Until then, they may describe themselves as “too sensitive”, “lazy” or “unable to cope”. In reality, these reactions are often the nervous system’s attempt to protect us.

Fight, Flight, Freeze Or Shutdown

Our nervous system continually assesses whether we are safe. When stress feels persistent or overwhelming, the body may move into fight or flight.

We might become irritable, restless, anxious or unusually controlling. The heart may race, muscles tighten and sleep become disturbed. At other times, the system may shift towards freeze or shutdown, showing up as exhaustion, emotional numbness, procrastination, forgetfulness or a strong desire to withdraw.

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When Everyday Reactions May Signal Overload

For example, someone who becomes disproportionately angry over a minor delay may not simply have an “anger problem”; their system may already be carrying days or months of accumulated stress. Another person may sit before a simple email for hours, unable to respond.

What looks like avoidance may actually be a freeze response. Some people remain highly productive while feeling disconnected from their bodies, until headaches, digestive difficulties or fatigue begin demanding attention.

These signs do not automatically indicate trauma or a mental health condition. They are invitations to become curious: What has my system been carrying? When did I last feel rested, supported or genuinely safe?

Small Ways To Help The Body Feel Safer

If you notice these patterns, begin gently. Reduce unnecessary stimulation, eat regularly, protect your sleep and spend time with people around whom you do not have to perform. Slow breathing—particularly allowing the exhale to be longer—may help signal safety. You can also look around the room, notice your feet on the floor and name what you can see and hear. Small, repeated experiences of safety are often more helpful than forcing yourself to “calm down”.

If symptoms persist, interfere with daily life or feel difficult to manage alone, speaking with a trauma-informed therapist can help you understand the patterns beneath them. Therapy is not only for moments of crisis; it can offer a safe space to listen to what the nervous system has been communicating all along.

The body is rarely working against us. Often, it is asking for care in the only language it knows.

By Ms Arouba Kabir, Psychologist & Therapist, Founder - Enso Wellness

Someone who is dying may start to their loved ones who passed away years ago. This could be unsettling and confusing for families and relatives who may assume that the person is just hallucinating or undergoing a deeper neurological issue.

But hospice physician Dr Christopher Kerr says such experiences are a known phenomenon called end-of-life dreams and visions (ELDVs). Kerr, chief medical officer of Hospice Buffalo, has spent decades studying these experiences in dying patients extensively.

Appearing on The Oprah Podcast, he told Oprah Winfrey that many patients near death describe seeing deceased relatives or people who cared for them during their lives. The experiences can feel completely real to them.

Why Do People Near Death See Deceased Loved Ones?

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One of the possibilities is that the brain experiences significant changes as the body starts to shut down.

Alterations in sleep, consciousness, metabolism, oxygen levels, medications, and brain chemistry can all affect perception during the final stages of life.

Dr. Rakesh Lalla, Additional Director - Neurology, Fortis Hospital, Mumbai, told HealthandMe, " These visions could be explained by the alterations that occur within the brain as the body starts to close down. Due to oxygen deprivation and altered brain activity, the brain would process memories, feelings, and stimuli differently. The areas responsible for memory processing and vision could become stimulated or disrupted, which could result in some vivid visions or experiences."

The expert also said that these visions do not mean that the person has a neurological or psychiatric issue.

Dr. Lalla said, "They do not necessarily mean that the person is confused or suffering from a psychiatric condition. In many cases, they are brief, peaceful, and emotionally meaningful to the individual. We still do not fully understand why particular people or memories appear."

The neurologist also advised families to stay supportive and calm during such situations.

He added, "The brain’s complex relationship between memory, emotion and perception is likely to play an important role. For families, the key is to remain calm, listen without dismissing the experience, and provide reassurance and comfort."

Also read: Global Life Expectancy Returns To Pre-Pandemic Levels, But NCDs Resulted In 8 Out 10 Deaths: WHO

Hallucinations Or Part Of The Dying Process?

Experts who have been studying ELDVs have also found that these experiences have some distinctive patterns that do not resemble random hallucinations.

In a 2014 longitudinal study led by Kerr, most of the 59 hospice patients who completed the study reported at least one dream or vision. Almost half occurred during sleep, and nearly all patients said the experiences felt real. The most common involved deceased friends or relatives or other loved ones. In fact, comforting visions of deceased people became more common as patients moved closer to death.

A 2026 systematic review of 13 studies similarly found that ELDVs occurred in at least one in five dying adults.

The National Institute on Aging also states that dying people may appear to see or talk to someone who is not present and may report dreams involving deceased relatives or friends. Such experiences are often comforting, and caregivers are generally advised not to immediately correct or challenge the person.

Seeing Loved Ones Could Be A Comforting End

Kerr said that patients seeing deceased loved ones in their visions appeared calmer afterward. His research suggests that these experiences may carry deep emotional meaning for patients.

“Very little is said between the person in the dream and the dreamer, but everything seems to be understood,” Kerr told Oprah.

Scientists still cannot say exactly what produces these experiences or whether they represent anything beyond changes occurring in the dying brain.

India accounts for one-fifth of global deaths due to cardiovascular diseases (CVDs) or complications related to the heart and blood vessels. Moreover, women are more vulnerable to these complications. Recent data show that women (14%) have a higher prevalence of CVD than men (12%), making preventive care very important for all.

When Should A Heart Check-up Be Done?

The human heart works constantly and efficiently and can compensate for metabolic stress and narrowing of blood vessels without showing any obvious symptoms. Hence, a heart health evaluation should ideally take place when the person is feeling completely well, long before any warning signs appear.

While acute symptoms, such as chest pressure or tightness, unexplained breathlessness, fainting, or unusual fatigue on effort, demand immediate attention, true heart protection occurs through early and planned tests. While heart check-ups are routinely recommended starting at age 40, screening should ideally begin earlier, around ages 30 to 35, especially if risk factors are present.

Starting check-ups at age 30 is important because certain congenital and structural heart conditions remain completely silent for years, and early screening ensures timely, targeted treatment when it is most effective.

Regular screening helps detect and rule out underlying issues early, including congenital heart defects (commonly known as holes in the heart) and conditions such as Atrial Septal Defect (ASD), Ventricular Septal Defect (VSD), or Patent Ductus Arteriosus (PDA). Structural and muscle diseases, on the other hand, include valve disorders, heart muscle weakness, or abnormal thickening of the heart walls (e.g., Hypertrophic Obstructive Cardiomyopathy (HOCM)).

Key Risk Factors

In addition to age, patients should seek a heart check-up sooner if they have any of the following risk factors:

• Strong family history of premature heart disease in immediate relatives.
• History of active or past smoking and tobacco use.
• Metabolic conditions such as diabetes, hypertension, or elevated blood cholesterol.

Excess body weight, especially central or abdominal obesity. Excess body weight damages the kidneys, leads to fat deposits in the liver and increases the risk of developing diabetes, and ultimately increases the strain on the heart and blood vessels (cardiovascular system). These interconnected conditions are known as Cardiovascular-Kidney-Metabolic (CKM) syndrome and include heart disease, kidney disease, diabetes, stetotic (fatty) liver disease, and obesity.

Effective weight and metabolic management, through modern options such as oral or injectable GLP1 therapies, can improve long-term heart health.

Tailoring care

A heart check-up can involve several tests, from blood tests to invasive or non-invasive ones (with/without needles, catheters, or probes entering the body). The most common blood tests include fasting and post-prandial or after-meal blood sugar (FBG/PPBG), HbA1c (glycated haemoglobin), lipid and thyroid profile, and kidney function tests. Non-invasive cardiac tests include electrocardiogram (ECG), 2D echocardiogram, and ultrasound. However, not everyone needs all of them.

Diagnostic tests should be customized based on the person’s age, symptoms, and individual risk score. Hence, skip the urge to self-order commercial diagnostic packages online. Instead, take the most important step towards protecting your heart by talking to your doctor. A personalized assessment can help determine which tests, if any, are appropriate for you, so that you can focus on the right steps to keep your heart healthy.