High blood pressure and nosebleeds

Most nosebleeds start when small vessels in the front of the nose become irritated by dry air, nose picking, forceful blowing, injury, or local inflammation. High blood pressure is often symptom-free, so a bleed should not be used to infer its cause. If bleeding is prolonged or difficult to control, pressure, medicines, clotting problems, and the nose itself may all need assessment.

Blood-thinning medicines can increase bleeding or make it last longer, but never stop one without medical advice. Recurrent episodes deserve a review, particularly when they occur with easy bruising, heavy bleeding elsewhere, or a recent medicine change.

Sit upright, lean slightly forward, and breathe through your mouth. Pinch the soft part of the nose continuously for several minutes while keeping the head forward; do not tilt back or lie flat, because blood can run into the throat. Spit out blood rather than swallowing it. After it stops, avoid forceful blowing, picking, heavy exertion, and hot drinks for a while.

If the nose is dry, ask a pharmacist about a suitable saline product. Record how often bleeds occur and whether one side is affected, then arrange a review for repeated episodes.

Get urgent help if bleeding is heavy, follows a significant injury, causes faintness or breathing difficulty, or does not settle despite firm pressure. Call emergency services for chest pressure, severe breathlessness, sudden weakness, facial drooping, confusion, or trouble speaking.

Ask whether your pressure needs checking, whether any medicine affects bleeding, and whether the nasal lining needs examination. Confirm the correct first-aid technique and what duration or pattern should prompt an urgent review.