Increased conduit vessel stiffness results in increased characteristic impedance of the aorta and decreased arterial compliance, which cause an increase in systolic blood pressure (SBP) and pulse pressure as well as a decrease in diastolic blood pressure (DBP).
Local trauma is the most common cause, followed by facial trauma, foreign bodies, nasal or sinus infections, and prolonged inhalation of dry air. Children usually present with epistaxis due to local irritation or recent upper respiratory infection (URI).
Hypertension, however, is rarely a direct cause of epistaxis. More commonly, epistaxis and the associated anxiety cause an acute elevation of blood pressure. Therapy, therefore, should be focused on controlling hemorrhage and reducing anxiety as primary means of blood pressure reduction.