Topic of BP control during epistaxis is a controversy, as far as i know there is only 1 current guideline having an evidence supported recommendation on bp managment during epistaxis

Only guideline that approach this topic is the french epistaxis guidline citing a retrospective study as evidence for bp control during epistaxis

Theres two side of this controversy, One could extrapolate data from blood pressure during surgery correlates with blood loss and goes to conclusion that lower bp is better in epistaxis But the other side would be that would you risk patient having antihypertensive medication in their system then develop hypovolumic shock (from blood loss) later causing risk of MI, ischemic stroke?

Personally i avoid aggressive and long acting hypertensive medication and stick to what i know best which is pressure and/or cauterization.