 CVS 7

 Arterial blood pressure

 Arterial blood pressure is defined as the lateral pressure exerted by the column of blood on wall of arter-
ies. The pressure is exerted when blood flows through the arteries. Generally, the term ‘blood pressure’
refers to arterial blood pressure. Arterial blood pressure is expressed in four different terms:
 1. Systolic blood pressure
 2. Diastolic blood pressure
 3. Pulse pressure
 4. Mean arterial blood pressure.
 „SYSTOLIC BLOOD PRESSURE
 Systolic blood pressure (systolic pressure) is defined as the maximum pressure exerted in the arteries
during systole of heart.
 Normal systolic pressure: 120 mm Hg (110 mm Hg to 140 mm Hg).
 „DIASTOLIC BLOOD PRESSURE
 Diastolic blood pressure (diastolic pressure) is defined as the minimum pressure exerted in the arter-
ies during diastole of heart.
 Normal diastolic pressure: 80 mm Hg (60 mm Hg to 80 mm Hg).
 „ PULSE PRESSURE
 Pulse pressure is the difference between the systolic pressure and diastolic pressure.
 Normal pulse pressure: 40 mm Hg (120 – 80 = 40).
 MEAN ARTERIAL BLOOD PRESSURE
 Mean arterial blood pressure is the average pressure existing in the arteries. It
is not the arithmetic mean of systolic and diastolic pressures. It is the diastolic
 pressure plus one third of pulse pressure. To determine the mean pressure, dias-
tolic pressure is considered than the systolic pressure. It is because, the dias-
tolic
 period of cardiac cycle is longer (0.53 second) than the systolic period (0.27
second).
 Normal mean arterial pressure: 93 mm Hg (80 + 13 = 93).
 Formula to calculate mean arterial blood pressure:
 Mean arterial blood pressure = Diastolic pressure + 1/3 of pulse pressure
 80+ 40/3 = 93.3 mm Hg
 Factors maintaining arterial blood pressure
 A. Central factors, which are pertaining to the heart:
 1. Cardiac output
 2. Heart rate
 B. Peripheral factors, which are pertaining to blood and blood vessels:
 3. Peripheral resistance
 4. Blood volume
 5. Venous return
 6. Elasticity of blood vessels
 7. Velocity of blood flow
 8. Diameter of blood vessels
 9. Viscosity of blood.
 A. Central factors, which are pertaining to the heart:
 1. Cardiac Output
 Systolic pressure is directly proportional to cardiac output. Whenever the
cardiac output increases, the systolic pressure is increased and when cardiac
output is less, the systolic pressure is reduced. Cardiac output increases in mus-
cular exercise, emotional conditions, etc. So in these conditions, the systolic
pressure is increased. In conditions like myocardial infarction, the cardiac out-
put decreases, resulting in fall in systolic pressure.
 2. Heart Rate
 Moderate changes in heart rate do not affect arterial blood pressure much.
However, marked alteration in the heart rate affects the blood pressure by alter-
ing cardiac output.
 PERIPHERAL FACTORS
 3. Peripheral Resistance
 Peripheral resistance is the important factor, which maintains diastolic pressure.
Diastolic pressure is directly proportional to peripheral resistance. Periph-
eral resistance is the resistance offered to the blood flow at the periphery. Re-
sistance is offered at arterioles, which are called the resistant vessels.
 4. Blood Volume
 Blood pressure is directly proportional to blood volume. If the blood volume
increases, there is an increase in venous return and cardiac output, resulting in
elevation of blood pressure.
 5. Venous Return
 Blood pressure is directly proportional to venous return. When venous re-
turn increases, there is an increase in ventricular filling and cardiac output, re-
sulting in elevation of arterial blood pressure.
 PERIPHERAL FACTORS
 6. Elasticity of Blood Vessels
 Blood pressure is inversely proportional to the elasticity of blood vessels. Due to elas-
tic property, the blood vessels are distensible and are able to maintain the pressure.
When the elastic property is lost, the blood vessels become rigid (arteriosclerosis) and
pressure increases as in old age. Deposition of cholesterol, fatty acids and calcium ions
produce rigidity of blood vessels and atherosclerosis, leading to increased blood pres-
sure.
 7. Velocity of Blood Flow
 Pressure in a blood vessel is directly proportional to the velocity of blood flow. If the
velocity of blood flow increases, the resistance is increased. So, the pressure is in-
creased.
 8. Diameter of Blood Vessels
 Arterial blood pressure is inversely proportional to the diameter of blood vessel. If the
diameter decreases, the peripheral resistance increases, leading to increase in the pres-
sure.
 9. Viscosity of Blood
 Arterial blood pressure is directly proportional to the viscosity of blood. When viscos-
ity of blood increases, the frictional resistance is increased and this increases the pres-
sure
Arterial blood pressure is 1. Cardiac output
directly proportional to 2. Heart rate
3. Peripheral resistance
4. Blood volume
5. Venous return
6. Velocity of blood flow
7. Viscosity of blood

Arterial blood pressure is 1. Elasticity of blood vessel

inversely proportional to 2. Diameter of blood vessel
 REGULATION OF ARTERIAL BLOOD PRESSURE
 Arterial blood pressure varies even under physiological conditions. However,
immediately it is brought back to normal level because of the presence of well
organized regulatory mechanisms in the body. Body has four such regulatory
mechanisms to maintain the blood pressure within normal limits
 NERVOUS MECHANISM FOR REGULATION OF BLOOD PRESSURE –
SHORT-TERM REGULATION
 Nervous regulation is rapid among all the mechanisms involved in the regulation of ar-
terial blood pressure. When the pressure is altered, nervous system brings the pressure
back to normal within few minutes. The nervous mechanism regulating the arterial
blood pressure operates through the vasomotor system.
 Vasomotor System
 Vasomotor system includes three components:
 1. Vasomotor center
 2. Vasoconstrictor fibers
 3. Vasodilator fibers.
 VASOMOTOR CENTER
 Vasomotor center is bilaterally situated in the
reticular formation of medulla oblongata and
the lower part of the pons.
 Vasomotor center consists of three areas:
 i. Vasoconstrictor area
 ii. Vasodilator area
 iii. Sensory area.
 i. Vasoconstrictor Area
 Vasoconstrictor area is also called the pressor
area. Vasoconstrictor area sends impulses to
blood vessels through sympathetic vasoconstric-
tor fibers. So, the stimulation of this area causes
vasoconstriction and rise in arterial blood pres-
sure. This area is also concerned with accelera-
tion of heart rate. (noradrenaline)
 ii. Vasodilator Area
 Vasodilator area is otherwise called depressor
area. This area suppresses the vasoconstrictor
area and causes vasodilatation. (acetylcholine)
 iii. Sensory Area
 This area receives sensory impulses via glos-
sopharyngeal and vagal nerves from the heart,
and vessels. Sensory area in turn, controls the
vasoconstrictor and vasodilator areas.