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

A 20-year-old UK student nearly died after accidentally taking two over-the-counter medicines that both contained paracetamol.

Riley Lubas, a first-year University of Bath student, developed a bad cold in March 2025. Days later, he developed severe stomach pain and was found to have serious liver damage.

What Happened?

Doctors initially suspected hepatitis, but Riley's condition rapidly worsened. He became delirious and hallucinated as his liver began to fail. His lungs and kidneys also stopped working, leaving him in multiple organ failure.

He was placed on life support and dialysis before being transferred to King's College Hospital in London, where doctors identified the cause after asking about his paracetamol use.

"It didn't necessarily help with a solution, but it was good to know the cause at last," his father, Chris, said.

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Riley Had To Learn To Walk And Talk Again

Riley was assessed for a liver transplant after his parents were warned that some of the damage could be "irreversible". But his liver began to recover.

"We watched Riley's situation closely for a couple of days, and he continued to improve, until he was taken off dialysis and life support just a week later."

Riley spent six weeks at King's College Hospital and later moved to an ICU in Newport. After a tracheostomy and multiple organ failure, he had to relearn how to speak and walk.

"But just seeing him up and alive again was unbelievable," his father said.

Riley has since recovered and returned to work as a bartender.

"It was mad how quickly it all escalated," he said.

"Because I was already sick, when my stomach hurt I just assumed I'd caught a stomach bug, so I didn't notice the pain in my liver specifically."

"I'm just so grateful that I was able to come out the other end alright."

Why Combining Cold And Flu Medicines Can Be Risky

Read More: Are GLP-1 Drugs Safe for Children? Study Finds Nutritional Deficiency in Nearly 17% Within a Year

Riley's case highlights the risk of taking multiple medicines without realizing they contain the same active ingredient.

Dr Will Mackintosh, a GP and chairman of RCGP Cymru Wales, said accidental paracetamol overdose in young people was "a fairly rare occurrence", but warned that people can inadvertently take two products containing paracetamol, BBC reported.

The Medicines and Healthcare products Regulatory Agency (MHRA) has warned that "simple misunderstandings" about medicines can have serious consequences, highlighting the importance of checking the ingredients beforehand.

The Royal College of General Practitioners Cymru Wales also advised people to "read the label carefully" before taking medicines.

How Much Paracetamol Is Safe?

For most adults, the usual dose is 500 mg to 1,000 mg at a time, with at least four hours between doses.

The usual maximum is 4,000 mg in 24 hours, although some people may need a lower dose because of their weight, liver or kidney problems, alcohol use or other health conditions.

The important point is to count paracetamol from all medicines, including cold and flu products.

How Can An Overdose Damage The Liver?

The liver breaks down paracetamol. When too much is taken, a toxic substance can build up and damage liver cells. Severe overdose can lead to liver failure and death.

Early symptoms may include nausea, vomiting and stomach pain, but serious poisoning may not cause obvious symptoms immediately. Later signs can include jaundice, confusion and extreme sleepiness.

What To Do After Taking Too Much

If you think you have taken too much paracetamol — including by combining medicines that contain it — seek urgent medical advice immediately.

Do not wait for symptoms. Early treatment can reduce the risk of serious liver damage.

Always check the active ingredients on painkillers and cold and flu medicines before taking them together.

Doctors at a Mumbai hospital successfully performed a complex coronary angioplasty on an elderly diabetic patient with severely calcified coronary arteries using an advanced technique called Intravascular Lithotripsy (IVL), helping restore blood flow to the heart despite multiple procedural challenges.

The patient, who had been experiencing symptoms suggestive of coronary artery disease, was found to have extensive calcium deposits in the coronary arteries. Further evaluation also revealed poor blood flow in the leg arteries, making conventional vascular access for the procedure difficult.

What Is Coronary Artery Calcification?

Coronary artery calcification is commonly seen in elderly individuals and people with long-standing diabetes. Excessive calcium makes the arteries rigid and narrow, often making routine angioplasty technically challenging and increasing the risk of incomplete stent expansion, which can affect long-term outcomes

Severely calcified coronary arteries remain one of the biggest challenges in interventional cardiology. The calcium makes the arteries extremely rigid, making it difficult to properly expand the stent. In such situations, conventional angioplasty alone may not be sufficient.

Despite the patient’s complex anatomy and poor peripheral vascular access, the team successfully performed the procedure through the radial artery in the wrist, avoiding access through the diseased leg vessels.

Also read: Stopping Ozempic, Wegovy, Mounjaro Linked To 22% Higher Heart Attack, Stroke Risk: Study

Breaking Deep Calcium Deposits In Artery Wall

To prepare the artery for stenting, doctors used Intravascular Lithotripsy (IVL), an advanced technology that delivers controlled sonic pressure waves to fracture deep calcium deposits within the artery wall. This allows the blood vessel to expand more effectively, enabling safe and optimal placement of the coronary stent.

IVL works on a principle similar to the technology used for breaking kidney stones, but it is specifically designed for heavily calcified coronary arteries. By modifying the calcium before placing the stent, we can achieve better stent expansion, reduce procedural complications and improve long-term outcomes in appropriately selected patients.

The procedure was completed successfully, with excellent blood flow restored to the affected coronary artery. The patient recovered well and was discharged in a stable condition.

Doctors say the case highlights how newer technologies are expanding treatment options for patients who were once considered extremely difficult to treat due to severe coronary calcification.

Advanced techniques such as IVL are transforming the management of complex coronary artery disease, particularly in elderly diabetic patients, allowing us to safely treat lesions that would have been significantly more challenging with conventional techniques alone.

The case underscores the growing role of advanced interventional cardiology in treating complex heart disease while minimising procedural risk and improving patient outcomes.

The biological landmarks that occur in a woman’s life include many factors and menopause is one of them. Menopause is usually identified with changes in menstrual cycle, hormone levels, hot flashes and even emotional health. Nevertheless, this stage of a woman’s life is also characterized by some other things and needs to focus on woman’s cardiovascular system.

Heart problems have long been considered as the problem that concerns mostly men. Nevertheless, today it is known that cardiovascular diseases still kill more women than anything else and take the lives of almost one-third of all women in the world.

The Hormonal Shift That Changes Heart Risk

Until menopause, estrogen gives the cardiovascular system a number of advantages. It maintains the proper state of the blood vessels and assists in cholesterol regulation and proper vascular functioning. But when the woman gets into menopause, the drop of oestrogen level can cause various internal alterations. They include the increase of LDL cholesterol level, the decrease of HDL cholesterol level, elevated blood pressure, metabolic alterations and abdominal fat accumulation.

All those alterations will increase the chance of getting cardiovascular diseases, such as coronary artery disease, stroke and heart failure. According to the American Heart Association, the women become at greater risk for cardiovascular diseases after going through the process of menopause.

Also read: Is Controlling BP Enough After a Brain Bleed? Doctors Explain How to Prevent Another Stroke

Why Women Need Proactive Heart Health During Menopause

On the other hand, women may suffer from various symptoms that are associated with heart disease but differ from those in men. For instance, fatigue, breathlessness, nausea, lightheadedness, jaw pain, back pain or arm pain can sometimes go unnoticed and are misdiagnosed.

Therefore, awareness and medical consultation are vital. Health checkups, blood pressure and cholesterol monitoring, living healthy, eating healthy and individualized medical advice can greatly help in decreasing risks in the future.

Also read: Preeclampsia May End With Pregnancy. Your Heart Risk May Not

The Role of Comprehensive Women’s Healthcare

Treatment for menopause should not be restricted to treating symptoms; it should include care during the entire period of health transition.

Every woman's individual health requirements and guidance through various phases of life should be in accordance with her health needs.

Redefining Menopause: A Phase of Awareness, Not Fear

Menopause should never be seen as a deteriorating process but as a turning point where women can assess the state of their health and adopt preventative measures for their healthcare.

Ahead of World Heart Day, the issue of women’s heart health should go beyond just treating heart diseases and focus on preventive measures. It is not only about asking: “how do we treat heart disease in women?” It is also about asking: “how do we detect risk factors and help each woman protect her heart during one of the most critical periods in her life?” For when women understand what is going on in their body, they get the ability to make the right decisions about their health.

By Dr. Anupama Gangwal, Senior Consultant – Obstetrics and Gynaecology, Cocoon Hospital, Jaipur