Does Having High Blood Pressure Cause Nosebleeds?

In most cases, high blood pressure does not cause headaches or nosebleeds. The best evidence indicates that high blood pressure does not cause headaches or nosebleeds, except in the case of hypertensive crisis, a medical emergency when blood pressure is 180/120 mm Hg or higher.

Heart conditions like hypertension (high blood pressure) and congestive heart failure can also cause nosebleeds, as can hypertensive crisis — a sudden, rapid increase in blood pressure that may be accompanied by a severe headache, shortness of breath, and anxiety, according to the American Heart Association (AHA).

High blood pressure, medically known as hypertension, is a blood pressure reading higher than 130/80 millimeters of mercury (mm Hg). Stage 2 hypertension is defined as a blood pressure greater than 140/90 mm Hg. It’s estimated that 108 million adults in the United States have high blood pressure, and only about a quarter of these people have their blood pressure under control. Having high blood pressure puts you at a heightened risk of developing potentially life-threatening conditions like a heart attack or stroke. High blood pressure is sometimes called the silent killer because it often doesn’t cause any noticeable symptoms. Nosebleeds generally are not a symptom of high blood pressure. However, there’s still debate whether people with high blood pressure get more frequent or severe nosebleeds. Here’s what the research says and when a nosebleed may be a sign of a medical emergency.

Does high blood pressure cause nosebleeds?

Whether high blood pressure causes an increased risk of nosebleeds remains a topic of debate. Although high blood pressure isn’t known to directly cause nosebleeds, it’s probable that it may cause the blood vessels in your nose to be more susceptible to damage and increase bleeding time. In a recent 2020 study, researchers used data from the Korean National Health Insurance Service to examine the risk of nosebleeds in people with high blood pressure. In a group of 35,749 participants, researchers found people with a history of hypertension had an increased risk of nosebleeds requiring hospital visits compared to people with no history of high blood pressure. According to the American Heart Association, high blood pressure doesn’t cause nosebleed unless you have extremely high blood pressure called a hypertensive crisis.

What is a high blood pressure (hypertensive) crisis?

A hypertensive crisis is a sudden spike in your blood pressure over 180/120 mm Hg that can be life-threatening. It’s a medical emergency that requires immediate medical attention. When your blood pressure reaches this level, you’re at a high risk of blood vessel damage that can lead to serious conditions like:

heart attack
stroke
kidney damage
eclampsia
eye damage
pulmonary edema

People experiencing hypertensive crisis often experience nosebleeds from damage to the blood vessels in their nose. Other common symptoms include:

headaches
severe anxiety
dizziness
shortness of breath
chest pain
confusion
nausea
vomiting

What are the symptoms of high blood pressure?

High blood pressure is often called the silent killer. It usually doesn’t produce noticeable symptoms unless you have a hypertensive crisis. The only way to know for sure if you have high blood pressure is to get a test. Although you may not be able to notice it without a test, chronic high blood pressure can raise your risks of developing a number of serious conditions like:

heart failure
heart attack
stroke
transient ischemic attack (TIA)
kidney disease

Can having high blood pressure with nosebleeds be a sign of another condition?

Almost half of American adults have high blood pressure. It’s relatively common to have high blood pressure and also experience nosebleeds for unrelated reasons. Exposure to dry air, picking your nose, and many other conditions can lead to nosebleeds. Experiencing nosebleeds and high blood pressure together can also be caused by use of illegal drugs like cocaine.

What can frequent nosebleeds be a symptom of?

Nosebleeds are often harmless. The most common cause of nosebleeds is nose-picking (medically termed “digital manipulation”). Conditions that dry out the membrane of your nose, some drugs, and injuries are also common causes. Here are some conditions that can directly or indirectly lead to a nosebleed.

allergies
cuts and scrapes in your nose
foreign objects stuck in nose
inhaling chemicals
inhaling cold or dry air
nasal cannula use
nose-picking
traumatic nose injury
upper respiratory infection
vigorous nose blowing or sneezing

Some conditions that affect your circulatory system may increase your chances of developing a nosebleed. These include:

alcoholism
cancer
blood vessel deformities
von Willebrand disease
hemophilia

A number of medications or drugs can contribute to nosebleeds. Some include:

illegal drugs like cocaine
nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, aspirin
platelet aggregation inhibitors and anticoagulants
supplements like vitamin E, ginkgo, or ginseng
nasal sprays

When to see a doctor

Most nosebleeds aren’t a sign of a serious condition. However, if bleeding lasts longer than 20 minutes, you have a heavy blood flow, or if it developed after a head injury, you should see a doctor. High blood pressure becomes more common with age. Visit your doctor regularly to monitor your blood pressure and track how it changes with time. Leaving high blood pressure uncontrolled puts you at risk of developing a number of potentially life-threatening conditions. If your blood pressure is higher than 180/120 mm Hg, you should seek immediate medical attention.

Takeaway

There’s still debate whether high blood pressure increases the chances of developing nosebleeds. People with high blood pressure may get more frequent or more severe nosebleeds, but more research is needed to fully understand the link. High blood pressure is often called the silent killer because it usually doesn’t cause noticeable symptoms. See your doctor if you have high blood pressure to learn how to best keep it under control.