Hello! Thank you for asking on HCM! I understand your concern, and would like to explain that t odifferentiate his nose bleeding and all the other associated complains, it is necessary to closely monitor his blood pressure frequently (several times daily). Cough and nasal congestion are less probably caused by hypertension. A local inflammation, like sinusitis should be excluded first by a careful physical exam and additional tests. An ENT specialist consult is necessary for this purpose. Somme routine lab tests, like complete blood count, PCR, nasal sinuses X ray study, etc should be performed for the differential. If the average BP value is abnormally high, then an antihypertensive therapy modulation should be sought. You need to discuss with your doctor (internist or cardiologist). Hope to have been helpful! Greetings! Dr. Iliri