Blood pressure

The pressure of blood in the arteries varies as the heart beats

heart contracts blood pressure highest / heart relaxes blood pressure lowest
inner walls of blood vessels are smooth - friction between blood and walls
friction is called peripheral resistance slows down flow of blood
little pressure lost > the blood passes through wide arteries offer little resistance to flow
elastic recoil of the artery walls pulsing of heartbeat gradually reduced in vessels far away
narrower arterioles / capillaries greater SA of vessel wall contacts blood resistance increase
slows down the flow
blood pressure doesnt go up -narrow so many of them - > cross-sectional area than artery
blood pressure falls when blood travels slowly through capillaries
blood pressure in arteries varies through day + affected by changes in blood vessels / heart works
smooth muscle in arteries contracts in response to nervous / hormonal stimuli
arteries constrict > raises blood pressure
smooth muscle relaxes arteries dilate blood pressure falls
constricting and dilating the arteries is one way in which the body controls local bp
changing pressure changes flow rate more blood can be delivered rapidly to exercising muscles
permanent change narrowing from atherosclerosis raise blood pressure permanent
health problems
measuring blood pressure is used as an indicator of the health of both the heart and the vessels
systolic blood pressure - heart is contracting strongly blood pressure highest first through cuff
diastolic blood pressure return to normal lowest pressure during diastole is sufficient to force
blood through the cuff
sphygmomanometer blood pressure measure
mm Hg systolic 120 / diastolic 80 (normal)
140/90 + hypertension / 90/60 hypotension
weakened heart hypotension damaged blood vessels less elastic -hypertension

Adam Clarke www.brain-freeze.co.uk

Describe the blood clotting process and its role in cardio-vascular disease
Blood clotting
The body has a system to prevent the bleeding of damaged blood vessels, named hemostasis. Such
system involves the clotting of blood (coagulation). Blood consists of various types of blood cells
suspended in plasma, which includes the red blood cells (erythocytes), platelets and white blood
cells (leukocytes). Out of these, platelets are the most important in the formation of blood clots.
Blood clots form through a 3-stage process as a means for the circulatory system to protect itself
from excessive loss of blood from damage to blood vessels and as a way to allow them to repair.
The first stage of the hemostasis system would be vasoconstriction, where the blood vessels narrow
as they contract their muscular vessel walls. This is important where its purpose is to slow the blood
flow, thus helping the clotting to start. Secondly a damaged blood vessel wall attracts activated
platelets so they attach to the damaged area, where they are held there by a protein (von
Willebrand factor). Where the platelets build-up a mesh of them is developed to cover the injury and
they release other proteins to attract more platelets, which altogether become a blood clot.
Additionally with the clot development, a blood clotting protein named thrombin is produced. This
protein converts fibrinogen (clotting protein that is usually dissolved in blood) into long strands of
fibrin (protein) used to form an area to keep in more platelets and blood cells. The strands from the
fibrin assist in the development of a clot by holding the platelets and proteins in place. Blood clotting
altogether can be seen as the process in which blood in its liquid form is transformed into a solid
(coagulation) by the activation of many factors.
Overall, this system has to be carefully controlled internally as too much blood clotting can block
blood vessels that are not bleeding. Because of this the body has methods of limiting the clotting
and dissolving any clots that are no longer required for protection. Problems can occur with clotting,
where if it is uncontrolled, small blood vessels in critical places can become clogged with clots. Such
clogged blood vessels in the heart can lead to heart attack and in the brain - strokes.

Adam Clarke www.brain-freeze.co.uk

Cardio-vascular disease (CVD)

This is a term used to describe a variety of diseases that affect the human heart and blood vessels,
such as coronary artery disease, heart attack/failure, high blood pressure and stroke (loss of brain
functions because of a disturbance in blood flow to it). CVD / heart disease in all its forms has
sometimes fatal consequence, where it causes over 25% of all deaths in England and Wales. CVD
refers to numerous types of heart and blood vessel problems but it is most used in reference to the
damage caused to them by a condition called atherosclerosis. This is the hardening of the arteries
where plaque (fatty deposit) builds up on the inside of them, until there it restricts or even blocks
the flow of blood through the artery. In the coronary arteries (heart) and carotid arteries (neck),
plaque is most likely to build up of all the arteries in the body.
The development of atherosclerosis begins with damage to the endothelial cells in the artery. This
can cause the built-up of lipids (fats), the base of which plaque will be formed. Platelets from the
blood form a sheet over the plaque which then narrows the artery. Additional damage to the
endothelial cells causes the formation of a clot which could possibly block the whole artery, leading
to a stroke or heart attack.
In this in this case that the clotting of blood and the bodys system of hemostasis can lead to harm or
potentially death. The platelets form at that particular place as a reaction to the damage caused the
lining of the blood vessel. The platelets can be damaging here as they form a cap over the plaque as
a means of preventing bleeding from the artery wall, but instead it builds up over plaque decreasing
the space in which blood can be transported through the lumen. Additionally chemicals from the
blood can build up because of the platelets and surrounding white blood cells helping to protect it
from disease. This can lead to atheroma in the arteries endothelial lining which can have a build up
of salts from the blood changing it into hardened plaque, thus making the artery wall harden and it
becomes less elastic than it needs to be. The condition from such build up and the atheroma is
atherosclerosis itself. Because of the plaque and blockage of some arteries, blood pressure may
increase for the others which can cause further damage to other arteries leading them to also
subsequently develop plaque.

Adam Clarke www.brain-freeze.co.uk