Blood pressure and its regulation Flashcards

1
Q

Define arterial blood pressure

A

Pressure exerted by blood flow on blood vessel walls

Arterial BP = CO x TPR

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2
Q

What value is considered to be normal blood pressure?

A

120mmHg/ 80mmHg - This is the value considered sufficient for enough perfusion and O2 transport to tissues and organs

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3
Q

What do the top and bottom values of blood pressure show respectively?

A
  • Top = systolic pressure - Blood pressure in brachial artery during ejection of blood via left ventricle
  • Bottom = diastolic pressure - Blood pressure in brachial artery during relaxation and filling of left ventricle
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4
Q

What can blood pressure tell us about?

A
  • Heart rate
  • Stroke volume
  • Whether vessels constricted or dilated
  • Blood flow to tissues

Due to Arterial BP = CO x TPR

CO = SV x HR

Therefore, BP = SV x HR x TPR

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5
Q

What values are considered high and low for blood pressure?

A

High - >140/90

Low - systolic <80, diastolic <60

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6
Q

What are causes of hypertension?

A
  • Excessive vasoconstriction - exercise induced
  • Excessive blood volume overload
  • High LDL cholesterol - plaque formation, decreases diameter of blood vessels
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7
Q

What are causes of hypotension?

A
  • Hypovolemia
  • Excessive vasodilation
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8
Q

What are possible consequences of hypertension?

A
  • Myocardial infarction
  • Heart failure
  • Blood vessel damage
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9
Q

What are possible consequences of hypotension?

A
  • Poor O2 transport and blood flow (poor organ perfusion)
  • Ischemia (loss of oxygen)
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10
Q

What component of the autonomic nervous system involved in regulation of BP?

A

Sympathetic nervous system - responds to decrease in BP

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11
Q

What are the mechanisms that respond to or increase low BP?

A
  • Sympathetic nervous system
  • RAAS (renin-angitensin-aldosterone system)
  • Anti-diueretic hormone (ADH or called Vasopressin)
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12
Q

What is the mechanism that responds to and reduces raised BP?

A

Cardiac Natriuretic Peptides

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13
Q

How does the sympathetic nervous system raise BP?

A

A drop in blood pressure due to decrease in HR< SV or TPR, stimulates baroreceptor reflex, which then stimulates sympathetic nervous system

Can also be stimulated when fear-fight-flight response activated or during exercise :

  • Innervates into adrenal gland, releases adrenaline, which can then bind to B1 adrenoceptors on heart, increasing cardiac muscle contraction rate and stroke volume
  • Can act via noradrenaline, can increase heart rate via beta 1 binding, but can also bind to alpha 1 receptors on blood vessels to increase vasoconstriction, therefore increasing TPR
  • Innervates RAAS (renin-angiotensin,aldosterone system)
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14
Q

How does RAAS raise blood pressure?

A

Sympathetic nervous system recognises drop in blood pressure/ blood flow to kidneys:

  • Kidneys release renin
  • Renin converts angiotensinogen (released from the liver) into angiotensin I
  • When angiotensin I travels through the blood and lungs, it is converted into angiotensin II
  • Angiotensin II activates AT1 receptor (angiotensin 1), found on blood vessels and adrenal glands
  • On blood vessels, AgII binds to AT1 receptor, causes vasoconstriction, increases TPR
  • On adrenal gland, AgII binds to AT1 receptor, causes release of aldosterone, causes decrease H2O release, which increases blood volume, therefore SV, and therefore CO increases
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15
Q

How does ADH raise blood pressure?

A
  • ADH produced by neurones in hypothalamus, released from terminals into posterior lobe of pituitary gland, excreted into bloodstream
  • Secretion of ADH stimulated by:
    • Decrease in blood volume due to decrease in blood pressure
    • Decrease sensed by cardiac pressure receptors in LA, sends signals to hypothalamus
  • ADH causes vasoconstriction, therefore increase in TPR
  • ADH binds to receptors in nephron collecting duct, forms water channel increasing reabsorption of water, increasing blood volume, therefore increasing stroke volume, therefore increasing cardiac output.
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16
Q

How do Cardiac natriuretic peptides decrease blood pressure?

A

Atrial and Brain natriuretic peptides (ANP/BNP)

  • Released from specialised cells in atria
  • They sense the increase in cardiac filling pressure due to increase blood volume and blood pressure
  • An increase in cardiac filling pressure causes an increase in ANP/BNP secretion:
    • Signals kidneys to increase excretion of water, decreasing blood volume , SV and CO, therefore decreasing BP
    • Have direct effect on blood vessels, causes vasodilation, decreasing TPR, decreasing BP