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

Immunotherapy isn’t always better than chemotherapy. Its benefits depend on the cancer type, stage and biomarkers. Similarly, “superfoods” do not cure cancer, health experts said while addressing comedian Rahul Dua’s claims about cancer treatment.

On a recent podcast, Dua opened up about a family member’s four-year cancer battle and his research into alternative treatments.

Dua said his family member began improving after switching from chemotherapy to immunotherapy. He also claimed that low-cost drug combinations, including ivermectin and fenbendazole, could have potential in cancer treatment and questioned whether pharmaceutical profits influence which treatments receive attention.

But what does science say? HealthandMe spoke to oncologist to fact-check these claims and address common cancer-treatment myths.

Immunotherapy Isn’t Always Better Than Chemotherapy

“Immunotherapy is not universally ‘better’ than chemotherapy. Benefit depends on cancer type, stage, and biomarkers such as PD-L1, MSI-H or TMB,” said Dr Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital.

“In melanoma, mismatch-repair–deficient tumors and selected lung or kidney cancers, immunotherapy often outperforms or usefully combines with chemotherapy. In many other cancers, chemotherapy remains the backbone,” he added.

Patients should not decide their treatment on their own, the expert told HealthandMe.

Accurate diagnosis, staging and molecular testing require a multidisciplinary team. Shared decision-making with an oncologist is essential, as self-directed treatment choices can delay effective care and cause harm.

Also read: Wegovy & Zepbound Are Not Approved By US FDA For Children Under 12: So Why Are Prescriptions Rising?

‘Superfoods’ Don’t Cure Cancer

Dua also claimed that certain “superfoods” — including a high-protein, high-fat, low-fibre diet — combined with immunotherapy can cure cancer.

“‘Superfoods’ do not treat cancer. A balanced diet supports strength and treatment tolerance, but no food replaces proven therapy. Miracle-food claims lack rigorous evidence,” Dr Shyam said, stressing that patients should consult their oncologist for individualized, evidence-based care.

The Rs 50 Ivermectin-Fenbendazole Claim

Dua also spoke about a combination of ivermectin and fenbendazole, describing it as a “₹50 cancer treatment” that he believed could be more effective and questioned whether pharmaceutical profits were a factor.

“But since it was a 50 rupee cure. There is no profit for pharma in that. There is no profit for pharma in that. Off the record, there is this medicine combination of Ivermectin and Fenbendazole. Fenbendazole is a dog dewormer. It costs 20 rupees. Ivermectin is a horse dewormer. I am very convinced that as soon as my auntie moved from (4 years of) chemo to immunotherapy. (She) Started becoming better,” Dua shared during the podcast.

According to the American Cancer Society, ivermectin is not approved to treat cancer in people or animals, and no clinical guidelines recommend it as a cancer treatment.

"Ivermectin has not undergone the rigorous clinical trials needed to establish whether it is safe and effective as a cancer treatment in humans. Available research is insufficient to determine whether it could work as an anticancer drug," it says.

While ivermectin may be used at recommended doses to treat certain worm infections, large doses can be dangerous, potentially causing seizures, coma and even death. It may also worsen the side effects of standard cancer treatments such as chemotherapy.

Read More: Bill Ackman’s Daughter Gets Experimental Treatment For Vision Loss: When Can Mitochondrial Transplants Help?

Experts Warn Against ‘Miracle Cure’ Claims

Dua’s claims has drawn sharp criticism from oncologists, public health specialists and medical communicators, who warned that unscientific “miracle cure” claims could mislead patients into delaying evidence-based treatment.

“Don’t fall for this. A ₹50 cancer ‘cure’ that pharma is hiding is clickbait, not care. These people never follow it themselves and feel no responsibility when patients delay real treatment just so a video can go viral. Lives are not content,” Dr Rishabh Jain, Medical Oncologist, AIIMS Delhi, said on X.

Dr Arshiet Dhamnaskar, neurosurgeon at Western India Institute of Neurosciences, also said people not “trained in medical science should refrain from commenting upon it. As even one bit of misinformation can be disastrous.”

BBC News presenter Maryam Moshiri has opened up about her experience of living with an incurable blood cancer for the past two years.

Moshiri, 49, was diagnosed with Polycythemia Vera (PV) in November 2024. The condition affects the bone marrow and causes the blood to become thicker than normal.

While undergoing treatment, Moshiri has continued to work and has spoken about the challenges of managing her condition alongside her career.

“I love what I do. I love being where the story is. I don’t want to allow blood cancer to stop me from doing my work,” she told The Times.

Maryam Moshiri Opens Up About Living With Blood Cancer

Moshiri’s treatment involves having blood removed to reduce the concentration of red blood cells, a procedure that can leave her feeling exhausted.

She has also opened up about the challenges of continuing to work while experiencing fatigue related to her cancer treatment.

“I was working 14-hour days, constantly on air, constantly having to think on my feet, and holding it together, despite the fact that I had this chronic tiredness and fatigue,” she was quoted as saying.

“When you’re doing live news, you have this rush of adrenaline, and you just have to get on with it.”

Moshiri, who is a mother of three children aged 13, 11 and 9, also highlighted how she has struggled with constant fatigue while managing family life.

What Is Polycythemia Vera?

Polycythemia vera is a disorder in which the bone marrow produces excessive amounts of blood cells. In PV, the major problem is an overproduction of red blood cells.

An increased number of red blood cells means a higher proportion of cells are circulating in the blood. This can make the blood thicker and increase the risk of blood clots, stroke and heart attack.

Doctors therefore pay close attention to a patient's hematocrit, which represents the proportion of blood made up of red blood cells.

One of the major treatment goals is to keep hematocrit below 45%, which helps reduce cardiovascular risks.

How Is Polycythemia Vera Treated?

One of the traditional ways of controlling PV is removing some blood. The procedure, called phlebotomy, involves taking blood from a vein to reduce the number of circulating red blood cells and bring the hematocrit level down.

For some patients, this can become a recurring procedure. They may need repeated blood draws even while receiving standard treatment. This treatment burden is one reason a new drug for PV has attracted attention.

FDA Approves Drug for Polycythemia Vera

Late last month, the US Food and Drug Administration (FDA) approved Mimrylo (rusfertide) for adults with polycythemia vera (PV).

The drug is the first approved treatment for PV that mimics hepcidin, a naturally occurring hormone that regulates iron in the body.

The approval is particularly significant for patients whose disease remains inadequately controlled despite existing treatment and who need frequent blood-removal procedures.

“People living with polycythemia vera have long faced the challenge of managing a chronic blood disorder with frequent blood draws,” said Tanya Wroblewski, Director of the Division of Nonmalignant Hematology at the FDA's Center for Drug Evaluation and Research.

The FDA granted priority review and approved the drug to Takeda Pharmaceuticals America.

Air pollution has now become an inevitable aspect in many Indian cities, whether it is vehicular emissions, dust from construction activities, industrial pollutants, or smoke from burning crops. Some of the worst pollutants from the health point of view are those comprising PM2.5 (particulate matter 2.5).

Particulate matter 2.5 means the fine particulate matter measuring 2.5 microns in diameter or smaller, which is roughly 30 times smaller than the diameter of a human hair.

Due to their microscopic size, these particles can enter deep inside the lungs and even the blood stream. The WHO and the IARC have labeled outdoor air pollution and particulate matter as a carcinogen, which implies that it can lead to increased risk of cancer.

How does PM2.5 increase cancer risk?

Long-term exposure to PM2.5 is responsible for causing inflammation and oxidative stress within the body. Inflammation and oxidative stress will eventually result in DNA damage leading to an abnormal growth of cells.

The link between exposure to PM2.5 and cancer is well-documented, with lung cancer being the most established one, while others are still under investigation. According to WHO guidelines, long-term exposure to PM2.5 is linked to higher lung cancer mortality rates, even at lower concentrations.

This is highly relevant to India because air pollution in many Indian cities exceeds WHO recommendations.

Also read: Exposure To Air Pollution May Harm Male And Female Fertility, Expert Reveals

Practical ways to reduce your exposure

Even though individual measures may not solve the problem of air pollution completely, they do help to minimize personal exposure.

1. Keep an eye on the daily air quality

Monitor the AQI index before engaging in any outdoor physical activity and on polluted days, try to reduce the amount of time you spend outdoors.

2. Avoid pollution peaks

Early morning and late evening are typically times when pollution level is high. Plan your outdoor activities on less polluted days.

3. Use an N95 mask

When going out, especially commuting, during the days of high pollution use an N95 mask that helps to filter fine particles.

4. Improve indoor air quality

Close windows during heavy air pollution and install a HEPA filter air purifier if needed, especially for kids, elderly people and those who suffer from lungs diseases.

5. Reduce indoor pollution sources

Do not smoke indoors; use less incense and mosquito coil indoors, and make sure there is a good ventilation system in the kitchen when you cook.

6. Take care of general lung health

Never smoke, keep physically active during the days of decent air quality, and eat nutritious food with lots of fruit and veggies.

The bigger picture

Protecting yourself from the health risks of PM2.5 can be done by both individual means and also collective efforts. More sustainable modes of transport, better emission control policies, improved waste disposal facilities, and sound urban planning practices will become necessary eventually. In the meantime, we only have our knowledge and preventive steps to safeguard our health.

By Dr. Reshma Puranik, Cancer Physician, MOC Pune