CVS: Control Of Blood Pressure Flashcards

1
Q

How is blood pressure regulated in the shorter term?

A

Baroreceptor reflex:

They adjust sympathetic and parasympathetic inputs to the heart to alter CO They also adjust sympathetic input to peripheral resistance vessels to alter TPR.

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2
Q

Where are baroreceptors found?

A
  • Aortic arch

- Carotid sinus

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3
Q

Why do the baroreceptors not control sustained increases in blood pressure?

A

They become insensitive.

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4
Q

Name the 4 neurohumeral pathways which control circulating volume and hence blood pressure.

A
  1. Renin- angiotensin-aldosterone system
  2. Sympathetic nervous system
  3. Antidiuretic hormone
  4. Atrial natriuretic peptide
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5
Q

Where us renin released from?

A

Juxtaglomerular apparatus (JGA)

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6
Q

Name 3 factors which stimulate renin release.

A
  1. Reduced na|Cl o distal tubule
  2. Reduced perfusion pressure
  3. Sympathetic stimulation of JGA
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7
Q

What are the consequences of the RAAS system?

A

Acts to increase BP.

  1. Vasoconstriction
  2. Stimulates Na+ readsorbtion
  3. Stimulates aldosterone (which then stimulates sodium readsorbtion)
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8
Q

Which is the main Ang II receptor?

A

AT1

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9
Q

What type of receptor is AT1?

A

G-protein coupled

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10
Q

What channel does aldosterone act on and what is the molecular mechanism it stimulates?

A

ENaC: activates apical Na+ channel and apical k+ channel (hence sodium is readsorbed and potassium is lost)

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11
Q

Name 2 substrates that ACE acts on.

A
  1. Angiotensin I

2. bradykinin

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12
Q

What is the role of bradykinin?

A

Vasodilator actions, hence its break down reduces vasodilation.

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13
Q

Describe how direct sympathetic stimulation at the kidneys increase blood pressure.

A
  • Acts on arterioles to reduce renal blood flow
  • Stimulates granule cells of afferent arteriole to release renin
  • Stimulates sodium readsorption from PCT
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14
Q

What is the main function of antidiuretic hormone?

A

Formation of concentrated urine by retaining water to control plasma osmolarity.

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15
Q

What is the main function of natriuretic peptides?

A

Promotes sodium excretion to lower blood pressure.

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16
Q

When are natriuretic peptides released?

A

They’re synthesised and stored in myocytes and released in response to stretch.

17
Q

What is the role of postaglandins?

A
  • Act as vasodilators
  • Locally acting enhance glomerular filtration and reduce sodium reabsorbtion
  • Act as a buffer to excessive vasoconstriction produced by SNS and RAAS
18
Q

Define hypertension.

A

Sustained increase in blood pressure.

19
Q

What is the clinical range of stage 1 hypertension?

A

> 140/90 mmHg

20
Q

What is the clinical range of stage 2 hypertension?

A

> 160/100 mmHg

21
Q

What is the clinical range of severe hypertension?

A

> 180 systolic or >110 diastolic

22
Q

Give some examples of causes of secondary hypertension.

A
  • Renovascular disease
  • Chronic renal disease
  • Hyperaldosteronism
  • Cushing’s sundrome
23
Q

Name some none-pharmacological approaches to treating hypertension.

A
  • Exercise
  • Diet
  • Reduce sodium intake
  • Reduced alcohol intake
24
Q

What drugs can be used to treat hypertension?

A
  • ACE inhibitors
  • Ang II receptor antagonists
  • L-type calcium blockers
  • Alpha-1 receptor blocker (can cause posteral hypotension)
  • Diuretics