Physiology of blood pressure

What is blood pressure?

Blood pressure is the force that blood exerts upon the walls of the blood vessels or
chambers of the heart.

Components of blood pressure:-

There are two components of blood pressure include
1. Systolic pressure, which results from ventricular contraction.
2. Diastolic pressure, which results from ventricular relaxation.

Normal Blood Pressure:-

Average blood pressure varies by gender, race and tend to rise with age.
Men’s blood pressure:

 18–39 years: 119/70 mm Hg

 40–59 years: 124/77 mm Hg
 60 years and over: 133/69 mm Hg
Women’s blood pressure:

 18–39 years: 110/68 mm Hg

 40–59 years: 122/74 mm Hg
 60 years and over: 139/68 mm Hg

Factors That Influence Blood Pressure:-

 Cardiac output.
 Peripheral vascular resistance.
 Volume of circulating blood.
 Viscosity of blood.
 Elasticity of vessels walls

Blood pressure Regulation:-

Bp is mainly the result of cardiac output and systemic vascular resistance.
Bp is controlled by autonomic nervous system through baroreceptor reflex

The following mechanisms help regulate blood pressure:

Cardiac control
 The cardiovascular center provides a rapid, neural mechanism for the regulation of
blood pressure by managing cardiac output or by adjusting blood vessel diameter.
Located in the medulla oblongata of the brain stem, it consists of three distinct
regions:

1. The cardiac center stimulates cardiac output by increasing heart rate and
contractility. These nerve impulses are transmitted over sympathetic cardiac
nerves.

2. The cardiac center inhibits cardiac output by decreasing heart rate. These
nerve impulses are transmitted over parasympathetic vagus nerves.

3. The vasomotor center regulates blood vessel diameter. Nerve impulses

transmitted over sympathetic motor neurons called vasomotor nerves
innervate smooth muscles in arterioles throughout the body to maintain
vasomotor tone, a steady state of vasoconstriction appropriate to the region.

 The cardiovascular center receives information about the state of the body through
the following sources:
Neural Control
1. Baroreceptors are sensory neurons that monitor arterial blood pressure.
Major baroreceptors are located in the walls of the artries at the carotid sinus
(an enlarged area of the carotid artery just above its separation from the
aorta), the aortic arch, and the right atrium.They act as pressure sensors,
detecting changes in arterial BP through the stretch of the arterial wall. When
BP rises, arterial walls are stretched more and the baroreceptors are
stimulated to fire more frequently. If BP drops, the stretch of the arterial
walls decreases and the baroreceptors fire less frequently.

2. Chemoreceptors are sensory neurons that monitor levels of CO 2 and O 2.

These neurons alert the cardiovascular center when levels of O 2 drop or
levels of CO 2 rise (which result in a drop in pH). Chemoreceptors are found
in carotid bodies and aortic bodies located near the carotid sinus and aortic
arch.

3. Higher brain regions, such as the cerebral cortex, hypothalamus, and limbic
system, signal the cardiovascular center when conditions (stress, fight‐or‐
flight response, hot or cold temperature) require adjustments to the blood
pressure.

4. The heart has a dual nerve supply from the two branches of the ANS:
sympathetic and parasympathetic. Increasing sympathetic stimulation to the
heart increases the heart rate and the force with which it contracts. This
leads to an increase in stroke volume, producing an
 increase in Cardiac output. The same increase in heart rate and force of
contraction occurs in response to increased levels of the hormone
adrenaline.The decrease level of adrenaline and sympathetic activity will in
turn decrease the heart rate.

 The kidneys provide a hormonal mechanism for the regulation of blood

pressure by managing blood volume.
Hormonal mechanism
o The renin‐angiotensin‐aldosterone system of the kidneys regulates blood
volume. In response to rising blood pressure, the juxtaglomerular cells in the
kidneys secrete renin into the blood. Renin converts the plasma protein
angiotensinogen to angiotensin I, which in turn is converted to angiotensin II
by enzymes from the lungs. Angiotensin II activates two mechanisms that
raise blood pressure:

 Angiotensin II constricts blood vessels throughout the body (raising blood

pressure by increasing resistance to blood flow). Constricted blood vessels
reduce the amount of blood delivered to the kidneys, which decreases the
kidneys' potential to excrete water (raising blood pressure by increasing
blood volume).

 Angiotensin II stimulates the adrenal cortex to secrete aldosterone, a

hormone that reduces urine output by increasing retention of H 2O and
Na + by the kidneys (raising blood pressure by increasing blood volume).

Various substances influence blood pressure. Some important examples follow:

 Epinephrine and norepinephrine, hormones secreted by the adrenal

medulla, raise blood pressure by increasing heart rate and the contractility of
the heart muscles and by causing vasoconstriction of arteries and veins.
These hormones are secreted as part of the fight‐or‐flight response.

 Antidiuretic hormone (ADH), a hormone produced by the hypothalamus and

released by the posterior pituitary, raises blood pressure by stimulating the
kidneys to retain H 2O (raising blood pressure by increasing blood volume).

 Atrial natriuretic peptide(ANP), a hormone secreted by the atria of the

heart, lowers blood pressure by causing vasodilation and by stimulating the
kidneys to excrete more water and Na +(lowering blood pressure by reducing
blood volume).

 Nitric oxide (NO), secreted by endothelial cells, causes vasodilation.

 Nicotine in tobacco raises blood pressure by stimulating sympathetic
neurons to increase vasoconstriction and by stimulating the adrenal medulla
to increase secretion of epinephrine and norepinephrine.

 Alcohol lowers blood pressure by inhibiting the vasomotor center (causing

vasodilation) and by inhibiting the release of ADH (increasing H 2O output,
which decreases blood volume).