There is no one reason leading to epistaxis, and most of the time its cause remains unknown. We shall now see various reasons for the same. And then, we shall have a look at the relation between hypertension and epistaxis. Why Does Epistaxis Occur?

• Trauma (to the nose): This could happen because of nose picking, insertion of foreign bodies, excessive nose blowing, and even in case of a sharp blow on the face.
• Irritation: This can be due to an allergy to a particular thing, or even due consumption of drugs like cocaine.
• Hereditary Hemorrhagic Telangiectasia: This is an autosomal dominant condition which weakens the capillaries and causes bleeding. Recurrent epistaxis is a common feature of this.
• Nasal Septal Disease: This is one of the less common causes of anterior epistaxis which includes Wegener's granulomatosis, mid-line destructive disease, tuberculosis, and syphilis.
• Hypertension: Hypertension is also tested as one of the reasons.
• Consumption of Alcohol : Excessive consumption of alcohol could also lead to epistaxis.
• Deficiency of Vitamin C or K: This is also said to be one of the reasons behind epistaxis
• Tumors: In case of a brain of nose surgery, hemorrhage can occur due to trauma.

It is noted that occurrence of epistaxis is more common in the winters. It is also researched that nose bleeding in children between 2 - 10 years of age, and in adults between 50 - 80 years, is more common. Types of Epistaxis

1. Anterior Bleeds This is the most common type of epistaxis. It occurs in the anterior, which is two-thirds of the nose, and is visible on the septum. This sort of bleeding can often be resolved by pinching the cartilaginous part of the nose or by pouring cold water on the head and laying the patient's head on a pillow, keeping his head hanging. Most epistaxis originates in Kiesselbach's plexus, which is the anterior portion of the septum, and has a rich vascular supply.
2. Posterior Bleeds In posterior epistaxis, the blood runs from the back of the throat making way through the nose. Bleeding is profuse in this case, because there are larger vessels near the sphenopalatine artery, behind the middle turbinate. Posterior bleeds requires immediate treatment and hospitalization. It is a fact that only 10% of the nosebleeds account for posterior bleeding.

Epistaxis and Hypertension Can hypertension cause epitaxis? Yes, it is known as one of the reasons causing epitaxis. However, it has always been a part of scientific and statistical controversy. Many research studies have claimed hypertension to be one of the reasons for epistaxis, whereas, there are also many research studies that have denied their correlation. Understanding the relevance of hypertension with epistaxis is important, as hypertension is very common in people, like epistaxis. Posterior epistaxis usually occurs in patients who have fragile vessels because of various ailments, and it needs immediate medical assistance. Hypertension is most common with elders. Doctors also agree that older patients usually come for severe epistaxis conditions. Hence, we are assuming that age of a person and the severity of the nose-bleeding are directly correlated, in a normal situation. A logical reason for this could be derived from the fact that, as one grows old, their blood vessels and arteries lose their elasticity. High blood pressure leads to damaging the arteries by scarring. This can reduce the contracting and retracting of the arteries, causing posterior nose bleeding. However, this is not the only reason why a posterior epistaxis occurs. There are other reasons for posterior epistaxis to occur as listed above. It is such a common ailment that most of the patients treat at home, unless it is of a recurring nature. Dr. Levitt said "Control your blood pressure. Folks with hypertension are nosebleed prone, if you have hypertension and a blood vessel breaks, better that it should break outside the cranial cavity than inside. That would cause a stroke. It's like God gave us a pop-off valve." I guess, even if the controversy of the correlation between hypertension and epistaxis is not established, we all know the diverse effects of hypertension, and we should try our best to avoid it. Don't ever take epistaxis lightly in case of recurring bleeding, immediately seek emergency medical help.