Nosebleed, or epistaxis, is one of the main emergencies in the area of otorhinolaryngology . It is estimated that 60% of people have at least one nosebleed during their lifetime; In most cases, the bleeding is a mild and self-limiting, that is, it resolves on its own, without any intervention; However, in some cases, it may need urgent medical attention. Despite the fact that it can have several causes – for example, dust in the air, allergies, trauma, infections, among others – and that, in most cases, it is not serious, high blood pressure is often detected during a nosebleeds . For this reason, some doctors suggest that uncontrolled high blood pressure is also a cause of nosebleeds! It is known that high blood pressure is a frequent disease, affecting more than 40% of adults and being one of the most important cardiovascular risk factors. However, the relationship between high blood pressure and nosebleeds is still not fully understood. What do we already know? During an episode of nosebleed, blood pressure values are indeed higher. However, we must not forget that anxiety and fear related to a more significant nosebleed can, by itself, increase blood pressure, as part of an alert reaction! The presence of high blood pressure increases the severity of the bleeding and makes it difficult to control , requiring more interventions to stop the bleeding. What is it that we don't know? Although blood pressure is often elevated during a nosebleed, this does not mean that uncontrolled hypertension is the cause of the nosebleed. There are still questions whether patients with high blood pressure have more episodes of nosebleeds than other healthy people. So what to do when there is a nosebleed and high blood pressure is detected? The priority is always to control the bleeding . If it is not self-limiting and is significant, urgent medical care may be necessary. The fact that high blood pressure values are detected during bleeding does not mean that the person has actually hypertension. Therefore, the question needs to be clarified. It is recommended that: Once the situation of acute nosebleed has been resolved, blood pressure should be measured, in a quiet environment and at rest; Ideally, several measurements should be taken on different days to confirm or exclude arterial hypertension. If you find that your blood pressure is actually high... … and if you do not have a previous diagnosis of high blood pressure, seek medical attention as this may have been the opportunity to identify an important cardiovascular risk factor that must be studied and controlled. … and if you have already been diagnosed with high blood pressure and the values are not controlled, talk to your doctor as it may be necessary to adjust your medication. Also remember In most cases, having a mild, self-limiting nosebleed is not serious, but it may be the circumstance that reminds you of the need to have your blood pressure checked more regularly. If you have frequent and heavy nosebleeds, talk to your doctor so that he can advise you on the need to assess and eventually control your blood pressure. Author : José Ferreira Santos Source: Spriano P. Epistaxis and hypertension: reviewing a complex relationship. Medscape 2023 Byun H, Chung JH, Lee SH, Ryu J, Kim C, Shin JH. Association of hypertension with the risk and severity of epistaxis. JAMA Otolaryngol Head Neck Surg 2020;147:1-7. Meet the cardiology clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
