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Cardiovascular > Endocrine regulation of vascular tone > Flashcards

Endocrine regulation of vascular tone Flashcards

1
Q

What are the functions of blood vessels?

A
  • Oxygenated, nutrition and removal of waste products
  • Carriage of blood- without haemorrhage or thrombosis
  • Maintenance of a steady head of prefusion pressure
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2
Q

What is a hormone?

A

A chemical substance produced in the body that controls and regulates the activity of certain cells or organs

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3
Q

What are the types of hormones?

A

Endocrine (classical)
Paracrine
Autocrine

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4
Q

Describe endocrine hormones

A

In distant cells/ organs

Thyroxine, calcitonin, adrenaline, oestrogen, testosterone

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5
Q

Describe paracrine hormones

A

In adjacent cells/ organs

Nitric oxide, endothelin, noradrenaline

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6
Q

Describe autocrine hormones

A

In the same cell/ organ

Endothelin, noradrenaline

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7
Q

What classical vasoactive hormones are involved in the renin-angiotensin system?

A

Angiotensin 11 (ANG 11)/ Aldosterone (Aldo)

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8
Q

What classical vasoactive hormones are involved in the SNS?

A

Noradrenaline/ adrenaline

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9
Q

What classical vasoactive hormones are involved in the hypothalamic regulation?

A

Arginine Vasopressin/ Anti-diuretic hormone

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10
Q

What classical vasoactive hormones are involved in the cardiac stretch receptors?

A

Natriuretic peptides- atrial and brain

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11
Q

Name other classical vasoactive hormones

A

Apelin, Ghrelin, Relaxin, Uromodulin, Urotensin 11

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12
Q

How is adrenaline involved in the fight-or-flight repsonse?

A

Tachycardia, increased cardiac contractility (beta 1), increased muscle blood flow, bronchodilation (beta 2), hypertension
Adrenal gland

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13
Q

How is noradrenaline involved in the fight-ot-flight response?

A 
Peripheral vasoconstriction (alpha 1), renal and splanchnic vasoconstriction, hypertension
Peripheral neurotransmitter
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14
Q

What hormones retain body sodium?

A

ANG11, Aldo

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15
Q

What hormones excrete body sodium?

A

ANP/BNP

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16
Q

What hormones retain body water?

A

ADH/AVP (ANG11, Aldo)

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17
Q

What hormones excrete body water?

A

ANP/BNP

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18
Q

What hormones increase cardiac output?

A

AD

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19
Q

What hormones decrease cardiac output?

A

NA

20
Q

What hormones increase blood pressure?

A

NA, AD, ANG11, Aldo

21
Q

What hormones decrease blood pressure?

A

ANP/BNP

22
Q

What medical conditions are mediated by ANG11/ Aldo?

A

Hypertension
Heart Failure
Diabetic Nephropathy

23
Q

What medical conditions are mediated by AD/ NA?

A

Hypertension
Heart Failure
Ischaemic Heart Disease

24
Q

What medical conditions are mediated by AVP (ADH)?

A

Hyponatraemia (low blood Na+) in heart failure

Hepatic Cirrhosis and SIADH (syndrome of inappropriate ADH production)

25
Q

What types of drugs are used in hypertension?

A

ACE inhibitors, angiotensin receptor blockers, mineralocorticoid receptor blockers, alpha-adrenoreceptor blockers, beta-adrenoreceptor blockers

26
Q

What types of drugs are used in heart failure?

A

ACE inhibitors, angiotensin receptor blockers, mineralocorticoid receptor blockers, beta-adrenoreceptor blockers, ANP/BNP analogues

27
Q

What types of drugs are used in angina pectoris?

A

Beta-adrenoreceptor blockers

28
Q

What are the ‘new’ endothelial hormones?

A

Nitric Oxide

Endothelin-1

29
Q

What effect does ACh have on blood cells

A

Causes endothelial cells to release NO so relaxes blood vessels

30
Q

What are the traditional risk factors of endothelium damage?

A 
Metabolic factors
Blood flow
Adhesion
Thrombosis
Vascular tone
Proliferation
Permeability
Inflammation
Genetic factors
31
Q

What are the causes of endothelial dysfunction?

A

Hyperlipidaemia, hypertension, diabetes mellitus, smoking, menopause, hyperhomocysteinaemia, poor diet, obesity/ inactivity, ageing
LESS NO, MORE ET-1

32
Q

What are the roles of NO and ET-1?

A 
NO= vasodilator, anti-aggregatory
ET-1= vasoconstrictor, pro-aggregatory
33
Q

Describe how NO is generated?

A

L-arginine- NO synthase- NO
O2 requirement
L-citrulline by-product

34
Q

Describe the action of NO

A

N0
GTP converted to cGMP via NO-haem guanylate cyclase
Relaxation

35
Q

How is NO stimulated?

A

Shear stress/ blood flow, acetylcholine, bradykinin, Substance P= Ca2+ release= NO synthase activity

36
Q

How else is NO sourced?

A

Organic nitrates/ nitroprusside

37
Q

How is NO generated inhibited?

A

L-Monomethyl arginine

Inhibits NO synthase

38
Q

Benefits of NO

A

Vasodilatory
Anti-proliferative
Anti-inflammatory
Anti-platelet

39
Q

Name NO therapeutics

A

Organic nitrates
Nitrosothiols
GC stimulators/ activators
PDE5 inhibitors (phosphodiesterase type 5)

40
Q

How does dietary nitrate lead to NO generation?

A
  • Ingestion of dietary nitrate
  • Nitrate absorbed from stomach and small intestine
  • Concentration of nitrate in the salivary gland
  • Nitrate excreted by kidneys
  • Lingual bacteria reduce nitrate to nitrite
  • Acidic conditions of stomach reduce nitrite to NO
  • NO and nitrite diffuse into portal circulation= NO oxidised to nitrite
  • Nitrite transported in arterial circulation
  • Nitrite reduced to NO in resistance vessels, causing vasodilation and lowering blood pressure
41
Q

Describe the actions of ET-1

A

PrepoET-1= Big ET-1 and ECE= ET-1= ET(A)R and ET(B)R

42
Q

What are the major actions at the ET(A) Receptor?

A

Vasoconstriction, hypertension, arterial stiffness, endothelial dysfunction, insulin resistance, aldosterone release, atherosclerosis, inflammation, fibrosis

43
Q

What are the major actions at the ET(B) Receptor?

A

Vasodilation, ET-1 clearance, Natriuresis

44
Q

What gaseous mediators could be used in the future?

A

CO, H(2)S, NO

45
Q

How can endothelin dysfunction be reversed?

A

May be achieved by diet, exercise, new drugs, crucial therapeutic target in vascular disease

Cardiovascular (52 decks)

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