Blood pressure


You may wonder why your primary care provider, or PCP, checks your blood pressure every time you go to his or her office. Blood pressure is checked at most points of medical contact because patients usually can’t feel that their blood pressure is high, and because many people in the CNMI have high blood pressure. The 2016 CNMI Non-Communicable Disease and Risk Factor Hybrid Survey found that more than half of all adults in the Commonwealth have high blood pressure.

High blood pressure, also known as hypertension, is often referred to as the “silent killer.” It’s possible to have no symptoms of high blood pressure until you have a terrible problem like a heart attack or a stroke. Your PCP monitors your blood pressure to help you keep it under control before it causes any serious health problems. This is called preventative health care. In this article, I focus on what’s called “primary hypertension.” This is the type of high blood pressure that isn’t caused by some other health problem like a kidney disorder or heart defect.

How does blood pressure affect the body?

Arteries are pipes that carry blood away from the heart to the rest of the body. The pressure inside these pipes is referred to as blood pressure. Blood pressure is measured using two numbers, written as, for example, 120/80, and spoken as “one hundred and twenty over eighty.” The first number, the higher one, is the pressure in the pipes when the heart is squeezing, and the second number, the lower one, is the pressure in the pipes when the heart is relaxed. High blood pressure increases strain on the pipe wall. Blood vessels under such a strain over time can thicken and clog in response, or break open and leak. Similar to how high water pressure can damage your water heater at home, important organs like the kidneys, eyes, and brain can easily be damaged by these clogged or leaky pipes and can result in kidney failure, loss of vision, dementia, and strokes.

Less commonly, if you have low blood pressure (below 90/60), there might not be enough of a push behind your blood to get it to flow adequately to your brain and body. This may make you pass out or feel weak and dizzy. If you take too much blood pressure medicine and your blood pressure goes low, you may have these feelings.

What is considered high blood pressure?

Ideal blood pressure is below 120/80. A blood pressure from 140-159/90-99 is called stage 1 high blood pressure. When you have this degree of high blood pressure over years, it can cause severe damage to your heart and blood vessels. A reading over 160/100 is considered stage 2 high blood pressure and can cause serious problems within a shorter period of time—months, weeks, or even days.

Your PCP may take a few readings of your blood pressure. Sometimes people are nervous about having their blood pressure checked or are anxious about being in a doctor’s office. Because of this effect, it’s a good idea to monitor your blood pressure outside of the doctor’s office as well, such as public screening events, or at the pharmacy. Through the months of May and June, the Commonwealth Healthcare Corp., in partnership with the Northern Marianas College Nursing Program, is conducting free blood pressure screenings every Saturday at Joeten Superstore from 10:30am to 12:30pm, and at several other local grocery stores.

What can be done to control blood pressure?

There are some risk factors for high blood pressure that you can’t control, like family history or age. However, even if you do have some risk factors that can’t be changed, you can still reduce your risk of having high blood pressure by eating a balanced diet, limiting salt intake, being physically active, maintaining a healthy weight, and avoiding tobacco and alcohol. Making healthy changes to your everyday routine carry little or no risk and can benefit your body in many other ways.

For those who already have high blood pressure, if you are able to lose weight, become more active, and eat a balanced, low-sodium diet, you may not need to take medication, but it’s important to consult with your PCP to see if this could be an option for you. Sometimes behavior changes alone may not be enough to control your condition. Making healthy changes to your lifestyle are still good for your health, and can complement the effect of medication.

Although it may be difficult to understand why you need to take a medication if you don’t feel sick, your PCP knows the importance of medication and will try to find the best choice for you. If you don’t like your blood pressure medicine, talk to your doctor. Approximately three out of four people don’t take their blood pressure medicine as instructed by their doctor, but not taking your medication as prescribed increases your risk of getting sicker. High blood pressure is something that you can control, but when it isn’t controlled, can cause serious health problems.

Dr. Elizabeth Kohnen is a physician with the Commonwealth Healthcare Corp.

Elizabeth Kohnen, M.D.

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