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

From being a macho dude, Bruce Willis’ personality has changed to becoming more ‘tender’ even as the 71-year-old action hero continues to battle dementia, according to his daughter Rumer.

“I’m so grateful I get to go see him,” Rumer, 37, said during a podcast interview. “Even though it’s different now, I’m so grateful.”

“There’s a sweetness. He’s always been this kind of macho dude, and there’s like a — fragile is not the right word, but — just a tenderness that maybe being Bruce Willis might not have allowed him in a certain way,” she added.

Bruce Willis is continuing into his third year living with the condition.

In March 2022, Bruce Willis, the media legend who dominated Hollywood in his prime, was diagnosed with dementia, and since then, his family has been sharing their struggle with his diagnosis and how slowly it has been taking a toll on his health.

The following year, his diagnosis was confirmed as frontotemporal dementia (FTD), which is a degenerative disease that slowly chips away at your motor skills, communication skills, etc. His wife, Emma Heming Willis, noted early signs were subtle changes in his speech, initially mistaken for a resurgence of his childhood stutter.

Rumer is the eldest daughter of Bruce and The Substance star Demi Moore, who were married from 1987 to 2000. The former couple also had Scout Willis, 34, and Tallulah, 32, together.

Although FTD is considered to be one of the rarest forms of dementia, Rumer said the disease is more “prevalent” than she realized.

“It’s wild to me. So many people come up to me now, and they say, ‘My uncle had FTD. My dad had this,” she said.

Bruce Willis Is Alive

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Earlier this year, in March, a hoax news of Bruce Willis’ death circulated. However, his representatives confirmed that the news is fabricated and that the actor is alive.

"He joins the long list of celebrities who have been victimized by this hoax. He's still alive and well. Stop believing what you see on the Internet," his official representative stated.

What Is Frontotemporal Dementia?

Frontotemporal dementia is a less prevalent type of dementia that mainly occurs in the frontal and temporal lobes of the brain. It tends to affect behavior, personality, language, and movement more than memory, particularly in its initial stages.

In contrast to Alzheimer's, which generally strikes older individuals, FTD can hit at an earlier age—sometimes as young as 40. The symptoms can range from changes in personality, emotional flatness, or the inability to show empathy to impulsiveness, so it is especially hard for spouses and children to cope.

Frontotemporal Dementia: Symptoms

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The Mayo Clinic states that the symptoms of FTD vary depending on the most affected part of the brain. The progression is gradual but relentless.

Behavioral symptoms:

• Socially inappropriate behavior.
• Loss of empathy and sensitivity to others.
• Poor judgment and impulsivity.
• Apathy that can be mistaken for depression.
• Compulsive habits such as tapping, clapping, or repetitive lip-smacking.
• Decline in hygiene.
• Odd eating habits – from sudden sugar cravings to chewing on non-food items.

• Trouble understanding and producing speech.
• Difficulty finding the right words.
• Using vague terms like “it” instead of specific words.
• Simplified, telegraphic speech.
• Errors in building sentences.

• Tremors, stiffness, or muscle spasms.
• Difficulty swallowing or weakness.
• Poor balance leading to falls.
• Inappropriate emotional outbursts, such as laughing or crying.
• The “wide-based gait” noted by Dr. Gartner falls into this movement-related cluster, aligning with the suspicion of FTD.

Even as injectable aesthetic procedures are gaining popularity as "cosmetic" treatments in beauty clinics and wellness centers across the country, the Central Drugs Standard Control Organisation (CDSCO) has tightened rules around cosmetic use.

In a new public notice issued this week, the CDSCO stated that cosmetic products that come in injectable form do not fall under the definition of cosmetics under the law. It said that such products are not permitted for use by consumers, professionals, or aesthetic clinics.

"Cosmetic means any article intended to be rubbed, poured, sprinkled or sprayed on, or introduced into, or otherwise applied to, the human body," the notice said.

It added that cosmetics are for "cleansing, beautifying, promoting attractiveness, or altering the appearance."

Thus, "products supplied in the form of injectable preparation do not fall under the definition of cosmetics. No cosmetic is permitted to be used as injection by consumer/professionals/aesthetic clinics," the notice added.

What Can No Longer Be Done

The new rules bar professionals and stakeholders from using or manufacturing any cosmetic product intended for injection or medical purposes.

The move also seeks to curb misleading advertising and unauthorised cosmetic practices by clinics and individuals.

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The regulator also warned against misleading claims and the use of prohibited ingredients in cosmetic products, saying such violations attract action under the Drugs and Cosmetics Act and Cosmetics Rules, 2020.

"Use of prohibited ingredients in cosmetic products, misleading claims on label, use of cosmetics for treatment, and application of cosmetics through injection attracts violations of the said Act & Rules," the notice said.

The regulator stated that no person shall alter, obliterate, or deface any inscription made by the manufacturer on the container or label of the product intended for use as a cosmetic.

The notice added that the list of generally not recognised as safe (GNRAS) and restricted ingredients is published by the Bureau of Indian Standards (BIS).

It has also encouraged the public and users to report any instance of misleading claims or violations through email and state licensing authorities.

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Why Injectable Beauty Clinic Therapies Are Under Scanner

The move follows several incidents of sub-standard cosmetic products found to be sold in the market, ranging from Botox parties in upscale salons to glutathione “skin whitening” drips offered in local aesthetic clinics.

Social media trends, celebrity endorsements, and growing demand for “preventive anti-ageing” treatments among younger consumers have driven the market for injectable beauty products, especially Glutathione drips, as well as detoxifying therapies, in the country.

Medical experts have also been raising concerns over their long-term safety and efficacy. As per experts, unregulated injectable procedures carry risks ranging from allergic reactions and infections to liver and kidney complications in extreme cases.

The new norms, thus, are part of the government's plans to strengthen the regulatory mechanism for cosmetics.

The government is also reportedly planning to designate a Central Cosmetics Laboratory to test cosmetic samples and may also designate any laboratory under its control for testing, according to Mint.

In addition, manufacturers will have to keep details and records of each batch and raw materials. Records are to be maintained for three years after the expiry of each batch. Imported cosmetic products shall bear a code number as approved by the State Licensing Authority.

Amid continuing heatwave conditions in northern India, prolonged exposure to extreme temperatures can trigger serious and potentially fatal medical emergencies, particularly among elderly individuals and cardiac patients, according to an expert.

The India Meteorological Department (IMD) has warned of severe temperatures across several states.

"Heat wave to severe heat wave conditions likely to continue to prevail over northwest & central India during the week and over East India during the next 5 days," the IMD said, in its latest update on May 20.

It added that severe heat conditions will persist for at least the next 72 hours across Delhi-NCR, Rajasthan, Uttar Pradesh, Punjab, and Haryana. Temperatures in several cities are expected to touch 47°C to 48°C, with Banda currently emerging as the hottest place in the country.

Dr. Vaibhav Mishra, Senior Director & Head, CTVS, Max Super Speciality Hospital, told HealthandMe that heat-related illnesses are not limited to discomfort or dehydration alone, and can rapidly worsen if early warning signs are ignored.

Heat Exhaustion Vs Heat Stroke

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There are two major heat-related illnesses that people must understand so that timely precautions can be taken — heat exhaustion and heat stroke.

"Heat exhaustion is a milder and more common condition and typically occurs after prolonged exposure to high temperatures or intense physical activity in the outdoors," Dr. Vaibhav said.

Excessive sweating leads to significant loss of water and salts from the body, resulting in:

• dehydration,
• fatigue,
• dizziness,
• muscle cramps,
• weakness,
• headache,
• nausea.

"However, if heat exposure continues and the body’s cooling mechanisms begin to fail, the condition can progress to heat stroke, which is a medical emergency. In heat stroke, body temperature often rises above 104°F," Dr Vaibhav told HealthandMe.

What may initially appear as confusion, disorientation, or irrelevant talking can rapidly worsen into:

• altered consciousness,
• seizures,
• coma,
• death.

How Heat Affects The Heart

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Dr Vaibhav said that to cool the body during extreme heat, the heart has to work harder and beat faster so that more blood can be directed towards the skin for heat dissipation.

"This places additional stress on an already weakened heart. Many cardiac patients are also on medications such as diuretics, which increase fluid loss and dehydration. Certain blood pressure medicines may blunt the body’s normal response to heat and delay warning symptoms," the expert told HealthandMe.

Dehydration further thickens the blood and, combined with increased cardiac workload, can significantly raise the risk of heart attacks, strokes, and dangerous rhythm disturbances.

How To Prevent Heat Stroke

Dr. Vaibhav stressed the critical need for early recognition of symptoms, especially in vulnerable individuals such as elderly people and cardiac patients, who are much more susceptible to heat-related complications.

Simple preventive measures can save lives. These include

• avoiding direct sun exposure during peak afternoon hours,
• maintaining adequate hydration,
• wearing loose cotton clothing,
• avoiding strenuous outdoor activity,
• never ignoring early symptoms such as excessive fatigue, dizziness, or confusion.