Body Systems

The Cardiovascular System

BIOL10811

Lecture 13:
Blood Pressure Regulation

Dr Nick Stafford
Division of Diabetes, Endocrinology & Gastroenterology
School of Medical Sciences
Faculty of Biology, Medicine and Health

nicholas.stafford@manchester.ac.uk
November 2023
 Objectives

A successful student should be able to

• Describe the determinants of blood pressure

• Describe the principals of blood pressure

regulation and its integrated control

• Describe the principals of local autoregulation and

central regulation of blood pressure

• Describe the mechanisms involved in the short-

and long-term regulation of blood pressure
 Content

1) Introduction to Blood Pressure Regulation

2) Intrinsic Control/Autoregulation of Blood Flow
3) Short Term Regulation of Blood Flow
• Baroreceptors
• Chemoreceptors
4) Long Term Regulation of Blood Flow
• Hormonal Regulation
• Role of Kidneys
5) Special Considerations for Local Flow
• Pulmonary Circulation
• Coronary Circulation
• Cerebral Circulation
 1) Introduction to Blood Pressure Regulation
What is blood pressure and why do we need it?

Blood Pressure

11
The force exerted upon vessel

re
tu
walls as blood flows through

c
Le
A minimum pressure (capillary
hydrostatic pressure) is required to
exchange substances/fluids across

14
capillary networks

re
tu
c
Capillary Exchange

Le
 Determinants of Blood Pressure

Total Peripheral
Blood Pressure = Cardiac Output X Resistance
Force exerted upon Dependent upon
HR X SV

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vessel walls as blood arteriolar radius

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flows through

Autoregulation
of local flow

Short Term central Long Term

Regulation Regulation
Neural Endocrine
 Content

1) Introduction to Blood Pressure Regulation

2) Intrinsic Control/Autoregulation of Blood Flow
 2) Intrinsic Control/Autoregulation of Blood Flow
When local blood pressure in tissues is too low…

Active Inactive
Tissue Tissue

Vasodilatory
Metabolites
NO
K+
CO2 H+
lactate
 Content

1) Introduction to Blood Pressure Regulation

2) Intrinsic Control/Autoregulation of Blood Flow
3) Short Term Regulation of Blood Flow
• Baroreceptors
• Chemoreceptors
 3) Short Term Regulation of Blood Flow
When blood pressure in tissues is still too low…

Autoregulation
insufficient to restore
homeostasis

Q Which branch of the autonomic nervous system could be activated to

restore BP? Sympathetic Parasympathetic
 3) Short Term Regulation of Blood Flow
When blood pressure in tissues is still too low…

Autoregulation
insufficient to restore
homeostasis

HR & SV vasoconstriction

Q Which branch of the autonomic nervous system could be activated to

restore BP? Sympathetic Parasympathetic
 3) Short Term Regulation of Blood Flow
When blood pressure in tissues is still too low…
Short term increase Activation of
in BP via SNS cardiovascular
centres in CNS Detected by
activation receptors sensitive
increasing CO and to
vasoconstriction pressure/chemical
changes

Autoregulation
insufficient to
restore homeostasis
 3) Short Term Regulation of Blood Flow
When blood pressure in tissues is still too low…
Short term increase Activation of
in BP via SNS cardiovascular
centres in CNS Detected by
activation receptors sensitive
increasing CO and to
vasoconstriction pressure/chemical
changes

Autoregulation
insufficient to
restore homeostasis

12
re
tu
c
Le
 Baroreceptor Reflexes Response enhanced by
Adrenaline/NA secretion
from adrenal glands
Cardioacceleratory
Carotid Centre Activation
Sinus HR & CO
(Cerebral Fall in Baroreceptor Cardioinhibitory
blood flow)
BP Inhibition Centre Inhibition

Vasomotor Centre
Baroreceptors

Aortic Vasoconstriction
Sinus
Activation

PNS
Cardiovascular
Centre in Medulla
Oblongata SNS

Cardioacceleratory
Centre Inhibition
HR & CO
Rise in Baroreceptor Cardioinhibitory
BP Stimulation Centre Activation

Vasomotor Centre
Vasodilation
Inhibition
 Chemoreceptor Reflexes
Respiratory Rate
HR & CO
Chemoreceptors

Cardioacceleratory Cardioinhibitory
Centre Activation Centre Inhibition

Respiratory Centre Fall in

Activation Fall in
Carotid pH
Body O2
(Blood) Rise in
Medulla
Rise in CO2
Oblongata
CO2 (CSF)

Vasomotor Centre
Vasodilation of Activation
cerebral vessels

Peripheral
Blood flow to Vasoconstriction
brain Coordination of cardiovascular
& respiratory response
 When blood pressure in tissues is STILL too low…
Short term increase Activation of
in BP via SNS cardiovascular
activation centres in CNS Detected by
increasing CO and receptors sensitive
vasoconstriction to
pressure/chemical
changes

Reflex responses
insufficient to
restore homeostasis

Autoregulation
insufficient to
restore homeostasis

Long term increase

in BP via increasing
Stimulation of
blood volume and
Endocrine
vasoconstriction
Response
 Content

1) Introduction to Blood Pressure Regulation

2) Intrinsic Control/Autoregulation of Blood Flow
3) Short Term Regulation of Blood Flow
• Baroreceptors
• Chemoreceptors
4) Long Term Regulation of Blood Flow
• Hormonal Regulation
• Role of Kidneys
 4) Long Term Regulation of Blood Flow
When blood pressure in tissues is too low…
Anti-Diuretic Hormone (ADH/vasopressin) Erythropoietin (Epo)

Fall in blood Fall in BP

volume or O2
Vasoconstriction
Vasoconstriction
Endocrine
Pituitary
Gland response Epo
ADH
to low BP RBC
Fluid Retention formation Blood
Thirst volume

Renin-Angiotensin-Aldosterone System (RAAS)

Lungs
Fall in Adrenals
renal BP
Angiotensin
Converting
Kidney Renin Enzyme

Angiotensinogen Angiotensin I Angiotensin II Aldosterone

Vasoconstriction Na+ Reabsorption

Liver Fluid Retention
 4) Long Term Regulation of Blood Flow
When blood pressure is too high….
Right
Atrium

Rise in Stretching of
Release of
cardiac muscle
BP & natriuretic peptides
cells in right atrium
volume ANP & BNP
and ventricle

Increased Na+ loss Renal

in urine Effects

Blood Increased water

volume loss in urine

Reduced thirst

Inhibition of ADH,
aldosterone, NA &
Blood adrenaline release
pressure
Peripheral Vascular
vasodilation Effects
Integrated Response to Regulation of Blood Flow
Short term increase Activation of
in BP via SNS cardiovascular
activation centres in CNS Detected by
increasing CO and receptors sensitive
vasoconstriction to
pressure/chemical
changes

Autoregulation
insufficient to
restore homeostasis

Long term increase

in BP via increasing
Stimulation of
blood volume and
Endocrine
vasoconstriction
Response
 Content

1) Introduction to Blood Pressure Regulation

2) Intrinsic Control/Autoregulation of Blood Flow
3) Short Term Regulation of Blood Flow
• Baroreceptors
• Chemoreceptors
4) Long Term Regulation of Blood Flow
• Hormonal Regulation
• Role of Kidneys
5) Special Considerations for Local Flow
• Pulmonary Circulation
• Coronary Circulation
• Cerebral Circulation
 5) Special Considerations for Local Flow
Blood flow regulation is different in some organs…
Pulmonary Circulation Coronary Circulation

In lungs arterioles constrict in A wide range of molecules regulate myocardial

regions of low O2 to shunt perfusion
blood flow to O2-rich areas

In other organs vessels

dilate when O2 falls
14 r e
ct u
Le

Cerebral Circulation

Blood flow to the brain must be

preserved at all times

In emergencies there is
Vasodilation of cerebral
vessels while there is
vasoconstriction in the
periphery
 Q Which mechanisms would be activated
following severe haemorrhage?

SNS Baroreceptor
activation Reflex

PNS
Autoregulation
activation

Chemoreceptor Endocrine
Reflex Mechanisms
Response to severe haemorrhage
 Objectives

A successful student should be able to

 Describe the determinants of blood pressure

 Describe the principals of blood pressure

regulation and its integrated control

 Describe the principals of local autoregulation and

central regulation of blood pressure

 Describe the mechanisms involved in the short-

and long-term regulation of blood pressure