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PRESSURE REGULATION
Definitions
Arterial blood pressure
Mean arterial pressure
= Diastolic + 1/3 pulse pressure
Physiological variations in BP
Age
Sex
Body mass index.
Meals
Exercise
Posture.
Anxiety
Determinants of ABP
Vasoconstrictor agents:
Noradrenaline
Sympathomimetic drugs.
Vasopressin
Angiotensin II
Endothelin-1
Blood Viscosity
Plasma Proteins:
Normal Plasma protein level:
Plasma protein
Hypoalbumenimia:
Burns.
Malnutrition
blood viscosity
Regulation of ABP
Short-term regulation:
Baroreceptor reflexes.
Chemoreceptor reflexes.
Atrial reflexes.
CNS-ischemic response.
Long-term regulation:
Role of the kidney.
Intermediate regulation:
Capillary fluid shift
Baroreceptors
Of these two sites for arterial baroreceptors, the carotid sinus is
quantitatively the most important for regulating arterial pressure. The
carotid sinus receptors respond to pressures ranging from 60-180
mmHg (Figure 2). Receptors within the aortic arch have a higher
threshold pressure and are less sensitive than the carotid sinus
receptors. Maximal carotid sinus sensitivity occurs near the normal
mean arterial pressure; therefore, very small changes in arterial
pressure around this "set point" dramatically alters receptor firing so
that autonomic control can be reset in such a way that the arterial
pressure remains very near to the set point. This set point changes
during exercise, hypertension, and heart failure. The changing set
point explains how arterial pressure can remain elevated during
. exercise or chronic hypertension
Long-Term:
Blood volume regulation by kidneys
Functions of Ang II
1. Constricts resistance vessels (via AII [AT1] receptors) thereby