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

As measles continues to spread across the United States, with recent case numbers climbing to their highest level in 33 years, growing numbers of Americans are becoming concerned about how at risk they may be.

Health officials in Philadelphia confirmed a potential measles exposure at Philadelphia International Airport and several public transport locations across the city in early January. The Centers for Disease Control and Prevention has also flagged earlier measles outbreaks across Pennsylvania, New Jersey, and New York City.

Adding to the concern, infectious disease tracker BMJGroup reported that measles cases recorded in 2025 are the highest seen since at least 1992.

Against this backdrop, it is important to understand whether measles can be fatal and to recognise the symptoms that should not be ignored.

Is Measles Deadly?

Yes, measles can be deadly and carries a significant risk of death, according to the Centers for Disease Control and Prevention.

“Measles can lead to serious health complications, including pneumonia, inflammation of the brain known as encephalitis, and death,” the CDC states. “Between one and three out of every 1,000 people infected with measles will die. Around one in five people with measles will require hospital care, and one in every 20 children with measles develops pneumonia, which is the leading cause of measles-related deaths in young children.

“One in every 1,000 people with measles will experience brain swelling, which can result in permanent brain damage.”

Measles Symptoms Develop In Three Stages

According to the Mayo Clinic, measles symptoms usually appear in three distinct stages.

Stage 1: Incubation period (10 to 14 days)

During this phase, there are typically no noticeable or warning symptoms.

Stage 2: Early symptoms begin

Symptoms at this stage may include a dry cough, fever, red and inflamed eyes known as conjunctivitis, a runny nose, and a sore throat.

Stage 3: Acute illness and rash

“In the third stage, a rash begins to develop, usually starting on the face. Small white spots called Koplik spots may appear inside the mouth two to three days after symptoms first appear,” the Mayo Clinic explains. “The measles rash typically shows up three to five days after the initial symptoms.

“Over the following days, the rash spreads to the arms, torso, and legs. Alongside the rash, fever often rises rapidly and can exceed 105 degrees Fahrenheit,” the guidance continues. “Eventually, the fever subsides, and the rash fades from the body starting at the head and moving downward.”

How Do You Treat Measles?

“If individuals aged six months or older are exposed to measles and do not have immunity from prior infection or vaccination, they can receive the measles vaccine within three days of contact with the virus,” the Mayo Clinic advises. “After vaccination, quarantine at home is not required.

“For children up to 11 months old who are exposed and are not immune, a dose of antibodies known as immune globulin can be given within six days of exposure to help the body fight the infection.”

Receiving this antibody treatment requires a 21-day quarantine period.

A notice has been issued for people who use the drug spironolactone. It is commonly prescribed for heart conditions, high blood pressure, and fluid retention. However, doctors say the medication is also used for several other health concerns.

According to the British Association of Dermatologists (BAD), spironolactone is prescribed “off licence” for women dealing with acne, female pattern hair loss, and hirsutism, a condition marked by excessive hair growth in areas such as the chin and upper lip. The NHS also states that spironolactone is a well-established and generally safe medicine that is sometimes used off licence to treat acne. Off licence means the drug is not officially approved for that specific condition under the UK prescribing licence.

Despite this, the NHS says spironolactone is available through the health service and is considered a useful alternative to long-term antibiotics. A study published in 2022 found that the drug is effective and safe for women who have persistent acne.

What Is Spironolactone?

Spironolactone, sold under the brand name Aldactone, is also used to help manage polycystic ovary syndrome, commonly known as PCOS. However, it is not usually prescribed to men for skin-related conditions.

While the medication can be helpful for many women, experts warn that it does come with side effects and certain dietary restrictions. Here is what patients should know before starting treatment.

How Does Spironolactone Work For Acne?

The NHS explains that spironolactone does not permanently cure acne, but it can help control breakouts and gradually clear the skin. The drug works slowly, meaning results are not immediate.

Most women begin to see improvement after about three months of use, but treatment usually needs to continue for at least six months. In some cases, it may take the full six months to experience the maximum benefit.

What Are The Side Effects Of Spironolactone?

For acne, spironolactone is usually prescribed at doses ranging from 50mg to 150mg per day. Many patients start with 50mg daily for the first month, depending on how well they tolerate the medication and whether any side effects appear.

If there are no concerning side effects and blood test results remain normal, a doctor may increase the dose to 100mg per day. NHS guidance says the tablets should be swallowed whole with water and taken after food.

Spironolactone Common Side Effects

• Sore or tender breasts
• Irregular periods, which may improve if combined with the contraceptive pill or a hormonal intrauterine device
• A drop in blood pressure when standing up, which can cause dizziness or light-headedness

Spironolactone Uncommon Side Effects

• Skin rashes
• Feeling drowsy
• Tiredness
• Headaches
• Reduced sex drive

Spironolactone Rare Side Effects

• Confusion
• Poor coordination
• Increased need to urinate, as spironolactone is a water tablet

Spironolactone Very Rare Side Effects

High potassium levels in the blood, especially in people over 45 or those with heart or kidney disease

Changes in kidney or liver blood tests, which usually return to normal if the dose is reduced or stopped

Cancer, which has been linked to very high doses in animal studies, but not seen in people taking standard doses.

The NHS advises that spironolactone should not be taken during pregnancy or while trying to conceive. It should also be avoided by people with Addison’s disease or serious kidney problems.

Alcohol can worsen certain side effects, such as dizziness, so cutting back on drinking is recommended. Reliable contraception should be used while taking spironolactone, and the combined contraceptive pill may help reduce side effects while also improving acne.

Spironolactone NHS Warning

Doctors advise that it is usually safe to try for a baby one month after stopping the medication. The NHS stresses the importance of informing your doctor about any other medicines you are taking before starting spironolactone. This includes ACE inhibitors, anti-inflammatory painkillers such as aspirin or ibuprofen, certain antibiotics, other diuretics, heart medications like digoxin, drugs for high blood pressure, and potassium supplements.

As per Mirror, people taking spironolactone are advised not to use low-sodium salt or salt substitutes such as Lo-Salt, as these products contain high levels of potassium. Using them alongside spironolactone can raise potassium levels to a dangerous range.

The NHS also recommends limiting foods and drinks high in potassium, including bananas, avocados, pulses, nuts, and salmon. A doctor or dietitian can help plan a low-potassium diet if needed.

Disclaimer:

This article is for general information only and is not a substitute for medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication, including spironolactone.

The NHS has issued advice for anyone taking a widely prescribed medication, warning of possible “serious” side effects. If you are currently on atorvastatin, it’s important to be cautious about what other medicines or supplements you take alongside it.

What Is Atorvastatin?

Atorvastatin belongs to a class of drugs called statins, which help lower cholesterol levels. It is usually prescribed for people with high cholesterol to reduce the risk of heart disease, including heart attacks and strokes.

NHS Issues Guidance on Atorvastatin

Your GP may also recommend atorvastatin if you have a family history of heart disease or a long-term condition such as type 1 or type 2 diabetes or rheumatoid arthritis. As with any medicine, it’s vital to follow official guidance on how to take it safely.

Atorvastatin: Interactions With Other Medicines

On its website, the NHS lists certain “cautions with other medicines.” This means you should check that atorvastatin is safe to take alongside any other drugs or supplements.

The NHS explained: “Some medicines can affect the way atorvastatin works and can increase the chances of you having serious side effects, such as muscle damage.” You should tell your doctor or pharmacist if you are taking any of the following:

• Antibiotics, including erythromycin, clarithromycin, rifampicin, or fusidic acid
• Antifungals, such as ketoconazole, voriconazole, or fluconazole
• Certain HIV medications
• Some hepatitis C treatments
• Warfarin, used to prevent blood clots
• Ciclosporin, for psoriasis or rheumatoid arthritis
• Colchicine, used for gout
• Contraceptive pills, such as the combined pill
• Blood pressure or heart medicines, including verapamil, diltiazem, or amlodipine
• Amiodarone, used for irregular heartbeats (atrial fibrillation)

If you need to take one of these medicines while on atorvastatin, your doctor may:

• Recommend a lower dose of atorvastatin
• Suggest a different statin
• Advise pausing atorvastatin temporarily

These are not all the drugs that can interact with atorvastatin. “For a full list, see the leaflet in your medicine packet or speak to your pharmacist,” the NHS said.

The health service also advised checking with your doctor or pharmacist before taking supplements like St John’s wort or CoQ10 while on atorvastatin.

Atorvastatin Common Side Effects

The NHS lists these common side effects, which affect more than one in 100 people:

• Nausea or indigestion
• Headaches
• Nosebleeds
• Sore throat
• Cold-like symptoms, such as runny or blocked nose, or sneezing
• Constipation or bloating
• Diarrhoea

“Drinking large amounts of alcohol regularly increases the risk of side effects and liver problems while taking atorvastatin,” the NHS added. “If side effects make you want to stop taking the medicine, speak to your doctor first. They may be due to another cause, and your doctor can suggest lowering the dose or switching medicines.”

Atorvastatin Serious Side Effects

Stop taking atorvastatin and contact a doctor or call 111 immediately if you experience:

• Unexplained muscle pain, tenderness, weakness, or cramps, which could indicate muscle breakdown and kidney damage
• Yellowing of the whites of your eyes or your skin, pale stools, or dark urine, which may signal liver problems
• Skin rash with pink or red blotches, particularly on the palms or soles, possibly indicating erythema multiforme
• Severe abdominal pain, a potential sign of acute pancreatitis
• Cough, shortness of breath, or unexplained weight loss, which could indicate lung disease
• Weakness in your arms or legs that worsens with activity, double vision, drooping eyelids, difficulty swallowing, or shortness of breath, which may be a sign of myasthenia gravis.