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 World Health Organization (WHO), notes that 36% of world's rabies deaths come from India, and a 2024 Lancet study notes that the country accounts for over one-third of global rabies deaths. When we spoke to Dr Aniket Mule, Consultant Internal Medicine at KIMS Hospital, Thane, he said that it is not just dog bites that lead to rabies, but it could happen from any rabies-susceptible animal. The first line of defense after you clear your wound immediately is to get the rabies vaccine. "Rabies vaccination is required for bites or scratches from any rabies-susceptible animal, including cats, monkeys, bats, foxes, and other wild mammals," he pointed out. As the country's apex court ruled and issued directives on stray dogs, focusing on public safety by ordering their removal, global health organizations, including WHO point out that this is not the right way to deal with rabies issue. Comprehensive methods including evidence=based strategies that center on mass dog vaccination is the key to the problem.

However, before this could be implemented, here's what you should know about dog bites and rabies.

What To Do After A Dog Bites Or Scratches You?

Dr Mule points out that even when there are minor scratches, without bleeding, you must get a rabies shot. "Rabies can be contracted through broken skin. Such exposures still require medical evaluation and, in most cases, rabies vaccination."

Read: In An 'Exceptionally Rare' Case, Man Dies Of Rabies After Kidney Transplant

What Should One Do Immediately After Being Bitten Or Scratched?

• Wash the wound immediately for at least 15 minutes with soap and running water
• Apply an antiseptic such as povidone-iodine
• Do not apply home remedies like turmeric, chili or oil
• Seek medical care promptly for rabies vaccination and possible immunoglobin

Dr Mule points out that the rabies vaccine should be started as soon as possible. "Ideally within 24 hours of a bite or scratch. However, even if there is a delay of days or weeks, vaccination should still be started immediately as rabies has a variable incubation period," he says.

After the bite, the immediate medical attention involves rabies post-exposure prophylaxis or PEP, and with a tetanus booster. Some rabies vaccines also use saline water as the diluent to reconstitute the freeze-dried powder before injection.

Read: Australia Issues Advisory Warning Travelers Of Counterfeit Rabies Vaccines Found In India

The temperature of the vaccine matters. "Rabies vaccines are temperature-sensitive and must be stored between 2°C and 8°C. Exposure to heat or freezing can reduce vaccine potency. Poor cold-chain maintenance is a known reason for vaccine failure in rare cases," points out the doctor.

Cases Of Rabies Coming Back After Vaccination Course Has Been Done

Dr Mule points out that in order to avoid such things happening, one must ensure immediate wound washing, timely vaccination, and correct use of Rabies Immunoglobulin or RIG. Rabies can come back if these following things occur:

• Delay in starting vaccination
• Failure to administer Rabies Immunoglobulin (RIG) in severe (Category III) exposures
• Improper wound cleaning
• Incorrect injection site (gluteal region)
• Poor vaccine storage (cold-chain failure)

Dr Mule points out that the vaccine should be given intramuscularly in the deltoid or upper arms for adults, as gluteal or buttock injections could lead to inadequate absorption and reduce effectiveness.

How Many Doses Should One Get?

• For someone not previously vaccinated, the current standard is 4 doses on days 0, 3, 7, and 14 (intramuscular schedule).
• In some government programs or intradermal schedules, 3–4 doses may be advised.
• Previously vaccinated individuals require only 2 booster doses (days 0 and 3).

The exact schedule depends on vaccination history and the protocol followed.

Winter in India is often associated with sardio ke laddoo, but also with increasingly sedentary lifestyle, worsening air pollution, all of which leads to more time spending home than to going out, taking a stroll, working out and more. This is why as winter sets in, India also sees a quiet but consistent rise in non communicable diseases, or NCDs, conditions that now account for nearly two thirds of all deaths in the country. Heart disease, diabetes, thyroid disorders, fatty liver disease and arthritis continue to rise across age groups, driven by sedentary lifestyles, dietary excess and delayed diagnosis.

Winter can further aggravate these risks. Physical activity drops, calorie dense foods become routine, sunlight exposure reduces and metabolism changes. Studies and hospital data in India have repeatedly shown that heart attacks and strokes tend to spike during colder months. Blood vessels constrict, blood viscosity increases and cholesterol levels often rise. Blood sugar control also becomes more challenging, while joint pain and stiffness worsen for many.

Dr. Mayanka Lodha Seth, Chief Pathologist at Redcliffe Labs, says the problem is not seasonal food but seasonal neglect. “Traditional winter foods are not harmful on their own. The real risk comes from consuming them without understanding what is happening inside the body,” she explains. “Winter tends to mask symptoms while quietly worsening internal imbalances.”

With India already home to over 100 million people living with diabetes and a similar number estimated to be prediabetic, preventive testing becomes crucial. Doctors recommend five key tests that can offer a clearer picture of health before winter indulgence begins.

Blood Sugar Levels

Diabetes is one of the fastest growing NCDs in India, and a large proportion of cases remain undiagnosed. Winter diets high in sugar and fat can trigger frequent glucose spikes. Testing fasting blood sugar and HbA1c helps identify early risk and prevents long term complications affecting nerves, kidneys and the heart.

Lipid Profile

High cholesterol is a major contributor to cardiovascular disease, which remains India’s leading cause of death. Reduced activity in winter often pushes lipid levels higher. A lipid profile helps assess heart risk and guides dietary and lifestyle moderation before damage sets in.

Liver Function Test

Non alcoholic fatty liver disease is increasingly common in India, even among younger adults. Excess sugar and fat intake during winter can worsen liver fat accumulation. Early liver testing can flag reversible changes before they progress to chronic liver disease.

Thyroid Function Test

Thyroid disorders affect millions in India, especially women, and often go unnoticed. Symptoms like weight gain, fatigue and cold intolerance are frequently brushed off as winter sluggishness. A simple thyroid test helps distinguish seasonal lethargy from hormonal imbalance.

Vitamin D and Vitamin B12 Levels

Vitamin D deficiency is widespread due to limited sun exposure in winter, while Vitamin B12 deficiency remains common because of dietary patterns. Both deficiencies are linked to low immunity, muscle pain, bone weakness and worsening joint discomfort.

Dr. Seth adds, “Preventive diagnostic testing allows people to make informed choices. It helps them enjoy winter foods in moderation without unknowingly worsening an underlying condition.”

As NCD related healthcare costs continue to rise in India, early testing offers both health and financial protection. Winter comfort does not have to come at the cost of long term health. Staying informed may be the most effective preventive step this season.

Flu season is hitting hard this year, and the symptoms could feel relentless. People are suffering from rising fever, hacking cough, blocked and stuffy nose and sore throat. While many people get relief from Tamiflu, which is a prescribed antiviral medication that is used to treat or even to prevent illness, there are other alternatives available too.

Dr Ari Brown, a Texas based pediatrician and the author of Baby411 book series told CNN health that one of the most common complaints that she gets to hear from Tamiflu is vomiting. A 2023 study published in the Pediatric Infectious Disease Journal notes that 18% of people experienced vomiting with Tamiflu, as compared to 5% with Xofluza, an alternative.

“I’ve also had a few pediatric patients experience moodiness with Tamiflu, which is reported in the literature,” she said.

Read: Adenovirus Cases Rise In UK, Health Authorities On Alert

Tamiflu is usually gives to treat flu in people ages 2 weeks and older and to reduce the chance of getting the flu in people 1 year and older. The medicine could be administered in both form, liquid and capsules and usually taken twice daily for five days straight. This is prescribed for when flu is to be treated. However, when used for prevention, it is typically taken once for 10 days.

What Are The Other Alternatives Available For Flu Treatment?

Xofluza: It is administered as a single dose tablet and is approved for ages 5 and older. This medicine can also be used to treat or to prevent the flu. While it costs nearly $200 for those without insurance, eligible patients can use coupons to lessen costs. Dr Brown points out that this medicine could have side effects like diarrhea and vomiting. However, the study aforementioned notes that for this, only 5% patients had vomiting symptoms, when compared with Tamiflu.

Dr Brown also said that Xofluza can stop viral shedding in one day, while Tamiflu could take up to three days. "Both antivirals will help reduce the duration of misery by couple of days," she pointed out.

Dr Brown also pointed out that overall, "Xofluza is rising in popularity over Tamiflu." “One dose. Fewer side effects. More insurances are covering the cost of it now and manufacturer coupon makes it less expensive than in previous years," she said.

Rapivab: This is another prescribed medication that is approved to treat flu. This could be administered for people ages 6 months and older. It has to be given by a health care provider, as it is given once as an intravenous infusion. It could cost up to $1,000 without insurance and most common reaction in adults is diarrhea.

Relenza: This flu medication is inhaled in powder form. It is administered through an inhaler device, which is to be used twice a day for five days straight. The prescribed drug is approved to treat flu in ages 7 and older and for preventative use, in ages 5 and older. It could cost about $90 without insurance.

It may have side effects like dizziness, allergic reaction, or irritation of the nose. It is not recommended for people who have breathing issues or have asthma.