Epistaxis during hypertension treatment

A nosebleed is bleeding from the delicate lining inside the nose. Dry air, irritation, allergies, infection, nose picking, or forceful blowing can disturb small surface blood vessels. High blood pressure does not explain every nosebleed, but a markedly raised reading can make bleeding harder to settle. Medicines that affect clotting may also lengthen bleeding; do not stop prescribed treatment without advice.

A single minor episode is often manageable, but repeated bleeding deserves a review of blood-pressure control, nasal dryness, medicines, and other conditions such as chronic kidney disease or heart failure.

Sit upright and lean slightly forward so blood does not run down your throat. Pinch the soft part of the nose continuously with thumb and finger while breathing through your mouth. Spit out blood rather than swallowing it. Once it stops, avoid blowing or picking the nose and avoid strenuous activity for the rest of the day. Check your blood pressure when you are calm, using your usual method, and record the result and your medicines for a clinician.

Seek urgent care if bleeding is heavy, follows an injury, causes faintness or breathing difficulty, or continues despite sustained pressure. Get emergency help for a nosebleed with severe headache, chest pain, weakness on one side, confusion, or trouble speaking. Contact your prescriber soon for repeated episodes, very high readings, or bleeding after a medicine change.

Ask whether your blood-pressure readings and medicines need review, whether any medicine increases bleeding, and which nasal moisturising product is suitable. Mention how long each episode lasts, which nostril bleeds, triggers, and any dizziness.