BLOOD PRESSURE

SURESH BABU EMANDI M.Pharm

Vikas Institute of Pharmaceutical Sciences

Near Air Port, Rajahmundry,
Andhrapradesh-533102.
 DIFINITION
 Blood pressure is the force or pressure which the
blood exerts on the walls of the blood vessels.
 The systemic arterial blood pressure, usually called
simply arterial blood pressure, is the result of the
discharge of blood from the left ventricle into the
already full aorta.
 BP = 122/80 mmHg or BP = 16/11 kPa(Kilopascal)
 Systolic blood pressure.

• When the left ventricle contracts and pushes blood into the aorta the
pressure produced within the arterial system is called the systolic
blood pressure.
• In adults it is about 120 mmHg (millimetres of mercury) or 16 kPa
(kilopascals).
 Diastolic blood pressure
• When complete cardiac diastole occurs and the heart is resting
following the ejection of blood,
• The pressure within the arteries is called diastolic blood pressure.
• In an adult this is about 80 mmHg or 11 kPa.
• The difference between systolic and diastolic blood pressures is the
pulse pressure.
• These figures vary according to the
• Time of day,
• The posture,
• Gender and
• Age of the individual.
• During bedrest at night the blood pressure tends to be lower.
• It increases with age and is usually higher in women than in men.
 Normal Values & Mesurements
• Arterial blood pressure is measured with a sphygmomanometer
• and is usually expressed in the following
• manner:
• BP = 122/80 mmHg or BP = 16/11 kPa
 The Elasticity of the artery walls
• There is a considerable amount of elastic tissue in the arterial walls,
especially in large arteries.
• Therefore, when the left ventricle ejects blood into the already full
aorta, it distends, then the elastic recoil pushes the blood onwards.
• This distension and recoil occurs throughout the arterial system.
• During cardiac diastole the elastic recoil of the arteries maintains the
diastolic pressure
 The Elasticity of the artery walls
• Systemic arterial blood pressure maintains the essential flow of
substances into and out of the organs of the body.
• Control of blood pressure especially to the vital organs is essential to
maintain homeostasis
 BLOOD PRESSURE
• The blood pressure is maintained within normal limits by fine
adjustments.
• Blood pressure is determined by cardiac output and peripheral
resistance:
• Blood pressure = Cardiac output x Peripheral resistance
 Cardiac output
• The cardiac output is determined by the stroke volume and the heart
rate.
• Increase in cardiac output raises both the systolic and diastolic
pressure.
• An increase in stroke volume increases systolic pressure more than it
does diastolic pressure
 Peripheral or arteriolar resistance
• Arterioles are the smallest arteries and they have a tunica media
composed almost entirely of smooth muscle which responds to nerve
and chemical stimulation.
• Constriction and dilatation of the arterioles are the main
determinants of peripheral resistance.
• Vasoconstriction causes blood pressure to rise and vasodilatation
causes it to fall.
• When elastic tissue in the tunica media is replaced by inelastic fibrous
tissue as part of the ageing process, blood pressure rises.
• Dilatation and constriction of arterioles occurs selectively around
the body, resulting in changes in the blood flow through organs
according to their needs.
• The highest priorities are the blood supply to the brain and the
heart muscle, and in an emergency, supplies to other parts of the
body are reduced in order to ensure an adequate supply to these
organs. Generally, changes in the amount of blood flowing to any
organ depend on how active it is.
• A very active organ needs more oxygen and nutrients than a
resting organ and it produces more waste materials for excretion.
 Control of blood pressure (BP)
• Blood pressure is controlled in two ways:
• short-term control
Baroreceptor reflex ,
Chemoreceptors and
Circulating hormones
• Long-term control, which involves regulation of blood volume by the
kidneys and the renin—angiotensin—aldosterone system (RAAS).
 The cardiovascular centre (CVC)
• The cardiovascular centre (CVC) is a collection of interconnected
neurones in the brain and is situated within the medulla and pons.
The CVC receives, integrates and coordinates inputs from:
• • baroreceptors (pressure receptors)
• • chemoreceptors
• • higher centres in the brain.
 The cardiovascular centre (CVC)
• The CVC sends autonomic nerves (both sympathetic and
parasympathetic) to the heart and blood vessels. It controls BP by
slowing down or speeding up the heart rate and by dilating or
constricting blood vessels.
• Activity in these fibres is essential for control of blood pressure . The
two divisions of the autonomic nervous system, the sympathetic and
the parasympathetic systems, are described more fully in Chapter 7.
• Their actions relating to the heart and blood vessels are summarised
The cardiovascular centre (CVC)
 Baroreceptors
• These are nerve endings sensitive to pressure changes (stretch) within
the vessel, situated in the arch of the aorta and in the carotid sinuses
and are the body's principal moment-to-moment regulatory
mechanism for controlling blood pressure.
• A rise in blood pressure in these arteries stimulates the
baroreceptors, increasing their input to the CVC.
• The CVC responds by increasing parasympathetic nerve activity to the
heart; this slows the heart down.
• At the same time, sympathetic stimulation to the blood vessels is
inhibited, causing vasodilatation.
 Baroreceptors
• The net result is a fall in systemic blood pressure. Conversely, if
pressure within the aortic arch and carotid sinuses falls, the rate of
baroreceptor discharge also falls.
• The CVC responds by increasing sympathetic drive to the heart to
speed it up.
• Sympathetic activity in blood vessels is also increased, leading to
vasoconstriction. Both these measures counteract the falling blood
pressure. Baroreceptor control of blood pressure is also called the
baroreceptor reflex
 Chemoreceptors
• These are nerve endings situated in the carotid and aortic bodies.
• They are primarily involved in control of respiration
• They are sensitive to changes in the levels of carbon dioxide, oxygen
and the acidity of the blood (pH).
• Their input to the CVC influences its output only when severe
disruption of respiratory function occurs or when arterial BP falls to
less than 80 mmHg.
 Higher centres in the brain
• Higher centres in the brain
• Input to the CVC from the higher centres is influenced by emotional
states such as fear, anxiety, pain and anger that may stimulate
changes in blood pressure.
• The hypothalamus in the brain controls body temperature and
influences the CVC which responds by adjusting the diameter of blood
vessels in the skin — an important mechanism in determining heat
loss and retention