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

In a global first, India's drug regulator has approved a fully synthetic cannabidiol (CBD) therapy for the treatment of mild to moderate anxiety disorders, marking a significant milestone in cannabinoid-based medicine.

The Central Drugs Standard Control Organisation (CDSCO) has granted regulatory approval to Zenara Pharma, the manufacturing partner of Leiutis Pharmaceuticals, to produce a synthetic cannabidiol oral solution (150 mg/ml). The prescription-only therapy is intended to be used alongside cognitive behavioural therapy (CBT) for managing mild to moderate anxiety disorders.

In a statement, Leiutis Pharmaceuticals said the approval follows a successful Phase III clinical trial conducted in India under CDSCO guidelines. A Phase IV post-marketing study will now be carried out to further evaluate the therapy.

World's First Fully Synthetic CBD Therapy

Leiutis noted that "this is the first regulatory approval anywhere in the world for a fully synthetic cannabidiol oral solution for anxiety disorders".

K. Chandrasekhar, CEO and Managing Partner of Leiutis Pharmaceuticals LLP, said the approval is the result of nearly a decade of cannabinoid research, including the development of a proprietary synthetic cannabinoid manufacturing process, novel drug-delivery technology, and extensive preclinical and clinical studies.

“Developed entirely in India and protected by patents in key markets, this approval is a significant milestone for our innovation pipeline, paving the way for next-generation cannabinoids. We thank the Government of India, clinical investigators, researchers and study participants who made it possible,” Chandrasekhar said.

What Is the New CBD Therapy?

The newly approved medicine contains a fully synthetic cannabidiol (CBD) active pharmaceutical ingredient (API), meaning no cannabis plant material is used in its production.

The therapy combines:

• A synthetic cannabidiol API developed by Biophore India Pharmaceuticals.
• Leiutis Pharmaceuticals' proprietary nanodispersible drug-delivery platform to improve absorption.
• Manufacturing by Zenara Pharma at facilities compliant with CDSCO, US FDA and European regulatory standards.

Biophore has also filed a United States Drug Master File (US DMF) for the synthetic CBD manufacturing process, reflecting internationally recognized quality standards.

Why This Approval Matters

The approval comes at a time when anxiety disorders are rising sharply in India. According to a recent analysis from the Global Burden of Disease Study published in The Lancet, anxiety disorders in India increased by 123.5% between 1990 and 2023.

The prevalence rose from 2,591.9 cases per lakh population in 1990 to 5,792.8 cases per lakh in 2023, driven largely by increasing rates of anxiety and depression.

What Is CBD?

Cannabidiol (CBD) is one of the naturally occurring compounds found in hemp and cannabis plants. Unlike THC, it does not produce intoxicating effects.

CBD has been studied for several potential therapeutic uses, including:

• Reducing anxiety symptoms
• Relieving chronic pain
• Improving sleep
• Managing certain seizure disorders
• Reducing inflammation

The newly approved product, however, uses synthetic CBD, which is produced entirely in a laboratory rather than extracted from the cannabis plant. Synthetic CBD offers a highly consistent and contaminant-free formulation, helping standardize dosing and quality.

Does CBD Have Proven Medical Benefits?

CBD already has established medical use in certain seizure disorders in some countries and continues to be investigated for a range of other conditions, including anxiety, chronic pain, inflammation and schizophrenia.

CBD is generally well-tolerated, but some users may experience mild side effects like drowsiness, reduced appetite, or diarrhea. Side effects are often due to interactions with other medications.

For many women, the last day of treatment feels like crossing a finish line they have been running toward for months. There is relief, there is gratitude, and there is often a quiet sense of disbelief that it is actually behind them. But finishing treatment is not really the end of the journey. It is the start of a new chapter—one we call survivorship—and it deserves just as much care and attention as everything that came before. Understanding what lies ahead can make all the difference between living in fear and living well.

Follow-Up Care Must Continue

Recovery does not mean walking away from the hospital. In the first few years after treatment, survivors are usually asked to return for follow-ups. The reason behind this is simple: if cancer ever returns, catching it early gives the best chance of treating it successfully. Or in many cases it a good habit to keep a check and boost confidence to the survivors.

Impact of treatment

What often surprises many women is that the impact of cancer treatment may continue even after active treatment ends. Recovery is a gradual process, and experiences can vary significantly from one individual to another depending on the type of cancer, treatment approach, and overall health. In terms of breast cancer, some women may continue to face physical, emotional, or lifestyle-related challenges during survivorship, while others may require ongoing therapies or follow-up care to reduce the risk of recurrence. What must always be remembered is that these issues cannot be addressed in silence. Open communication between the woman and her treatment team may allow problems to be sorted out in time, with the proper support being provided.

Emotional Health Deserves Equal Attention

Healing is not only physical. Many survivors carry a constant worry about whether the cancer will come back, while others feel strangely lost once the busy routine of treatment falls away. These emotions are completely natural and nothing to be ashamed of. Speaking to a counsellor, joining a support group, or simply being honest with the care team can lighten the burden enormously.

Healthy Habits Support Recovery

The choices made every day genuinely shape long-term health. Eating plenty of vegetables, fruits, and whole grains, and staying active with something as simple as a thirty-minute walk most days, makes a real difference. Keeping to a healthy weight is especially important, because carrying excess weight is linked to a higher chance of the cancer returningi. Cutting back on alcohol and staying away from tobacco add further protection.

Adjusting to Physical Changes

The body changes after cancer and coming to terms with this takes time. Worries about appearance and intimacy are entirely understandable, and they are worth raising during clinic visits, because often there are practical ways to help.

Be an Informed Advocate

No one understands a patient's body better than the patient herself, which is why every survivor should feel empowered to ask questions. Before treatment ends, it is wise to request a survivorship care plan. This is a summary of the treatment received, together with a clear schedule for future check-ups. Such a document becomes an invaluable guide, both for the survivor and for any doctor she may see in the years ahead.

Looking Ahead

Survivorship is rarely a straight line. There will be good days and harder ones, moments of confidence and moments of doubt. With regular check-ups, a few sensible habits, and the support of people who care, life after breast cancer can be every bit as rich and full as before—sometimes even more so. Because in the end, the goal of cancer treatment was never just to help women survive. It was always to help them truly live.

More than 57 million people worldwide are living with dementia, a number expected to triple to over 152 million by 2050. While there is still no cure, growing evidence suggests that healthy lifestyle changes can help improve brain health and preserve cognitive function in older adults at risk of dementia.

A major study published in The Lancet suggests that adopting healthy lifestyle habits can significantly improve memory and thinking skills in older adults at risk of dementia.

The study found that a culturally adapted, structured lifestyle program delivered across 11 Latin American countries produced meaningful improvements in cognitive function over two years. Participants in the intensive program showed 55 per cent greater improvement in overall cognition than those who received general health advice.

Lead author Lucia Crivelli, principal investigator at Fleni, a neurological institute in Buenos Aires, Argentina, said culturally adapted lifestyle interventions can be successfully implemented across diverse communities and "deliver cognitive benefits" for people at risk of dementia.

"Addressing multiple lifestyle factors can positively impact brain health and may eventually be combined with emerging drug therapies to reduce cognitive decline and dementia risk," added Heather M. Snyder, senior vice president of medical and scientific relations at the Alzheimer's Association.

What Did The Study Find?

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The clinical trial enrolled 1,065 adults aged 60 to 77 years at increased risk of cognitive decline across 12 sites in Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Peru and Uruguay.

Participants were randomly assigned to one of two groups. The Systematic Lifestyle Intervention (SLI) group received ongoing coaching, supervised exercise, personalized nutrition counselling, cognitive training and regular monitoring of cardiovascular risk factors. The Flexible Lifestyle Intervention (FLI) group received general lifestyle recommendations through periodic health education sessions without continuous coaching or supervision.

The structured program combined supervised exercise, a brain-healthy MIND diet, computer-based cognitive training, regular monitoring of blood pressure, blood sugar and weight, and social engagement activities designed to encourage accountability and interaction.

To improve participation, the intervention was adapted to local cultures. Exercise sessions incorporated familiar activities such as salsa and tango, while nutrition counselling focused on regionally available foods including avocado, quinoa, açaí, chia seeds, pumpkin seeds and aguaymanto.

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After two years, participants in the structured intervention experienced:

• 55 per cent greater improvement in overall cognitive performance than those in the flexible intervention group.

• The largest gains in memory.

• Significant improvements in executive function, including planning and decision-making.

• Faster processing speed.

The cognitive benefits were consistent regardless of participants' age, education level, ethnicity or genetic risk for Alzheimer's disease.

The authors noted that while the program improved performance on cognitive tests, it did not determine whether the intervention prevents dementia. They said longer-term follow-up is needed to establish whether these cognitive improvements ultimately reduce the risk of developing the disease.

What Is Dementia?

Dementia is an umbrella term used to describe a significant decline in mental function that is serious enough to affect everyday life. It commonly impacts memory, thinking, and reasoning skills. Dementia itself is not a single disease but a collection of symptoms caused by underlying conditions such as Alzheimer’s disease or vascular dementia.

Common signs include

• memory problems,
• confusion,
• difficulty finding words,
• changes in mood or behavior,
• trouble completing familiar tasks.