Hypertension and nosebleeds: what to know

Most nosebleeds start when delicate blood vessels near the front of the nose become dry, irritated or injured. Nose picking, forceful blowing, allergies and some medicines can contribute. High blood pressure is often symptomless, so a nosebleed should not be used to diagnose or dismiss it.

If bleeding is recurrent, difficult to stop or linked with easy bruising, a clinician can examine the nose, review medicines and check blood pressure. Blood-thinning medicines deserve special mention because they may prolong bleeding.

Sit upright and lean slightly forward. Pinch the soft part of the nose continuously while breathing through your mouth. Spitting out blood is safer than swallowing it. Once bleeding stops, avoid nose picking, forceful blowing, hot drinks and strenuous activity for a while.

Do not tilt your head back or keep releasing pressure to check too soon. Arrange a blood-pressure review separately if readings have been raised, and continue prescribed medicine unless a clinician tells you otherwise.

Seek urgent care if bleeding is heavy, follows a significant injury, causes faintness or breathing difficulty, or does not settle despite sustained pressure. Emergency help is also needed for a nosebleed with chest pain, severe headache, confusion, weakness or trouble speaking.

Ask whether a medicine, nasal treatment or dry air could be contributing, how to measure blood pressure correctly, and whether recurrent episodes need an ear, nose and throat assessment. Mention any bruising or bleeding elsewhere.