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ARTERIAL BLOOD PRESSURE

It is the pressure exerted by blood on the wall of a blood vessel, especially


pressure in arteries. It is determined by the rate and force of heart beat and
resistance to the flow of blood through vessels.

MEASUREMENT OF BLOOD PRESSURE

Blood pressure is measured by sphygmomanometer. Sphygmomanometer


consists of a rubber cuff attached by a rubber tube to a compressible hand
pump or bulb. Another tube attaches to the cuff and to a column of mercury
or pressure dial.
The cuff is wrapped around the power part of the upper arm and inflated by
squeezing the bulb. The bulb is squeezed until the blood pressure is raised
up to 200 mm Hg till pulse drops. The pulse is felt in two ways (1) by
placing the stethoscope and/ or (2) by placing the fingers over the radial
artery at the wrist. The pressure is slowly lowered by unscrewing the bulb
till the reappearance of the radial pulse.
The pressure at which radial pulse restarts or first sound is heard
corresponds to the systolic pressure. The pressure is lowered further, when
the sound becomes faint or disappears; the pressure recorded on the mercury
column corresponds to the diastolic pressure.

FACTORS AFFECTING ARTERIAL BLOOD PRESSURE

1. AGE - BP increases with age.


2. SEX – In females before menopause, SBP is 5 mm Hg less than that
in males.
3. EXERCISE – BP increases after exercise.
4. GRAVITY – The pressure in any blood vessel below heart level is
increased and that in any blood vessel above heart level is decreased
by the effect of gravity.
5. HEREDITARY – More prone in individuals with family history of
hypertension.
6. POSTURE – Upon sudden standing, DBP increases. It corrects after 1
min. to normal.
7. MEALS – SBP rises after meals.
DETERMINANTS OF ARTERIAL BLOOD PRESSURE

Arterial Blood Pressure – Cardiac output x Peripheral Resistance

Any factor altering the cardiac output or peripheral resistance will cause a
change in arterial blood pressure.

REGULATION OF BLOOD PRESSURE

There are various mechanisms that exist in human body which regulate the
systemic arterial blood pressure.
1. Rapidly acting regulatory mechanisms
2. Intermediate acting regulatory mechanisms
3. Long acting regulatory mechanisms

1. RAPIDLY ACTING REGULATORY MECHANISMS


They help to maintain blood pressure within normal range and prevents
from fluctuating to extreme high or low. They act within seconds of BP
becoming abnormal.

VARIOUS REFLEXES INVOLVED


1. Baroreceptor reflexes
2. Chemoreceptor reflexes
3. CNS Ischaemic response

2. INTERMEDIATE ACTING REGULATORY MECHANISMS


They begin to act within minutes of BP becoming abnormal. They alter
the blood volume and correct any change in BP.
MECHANISMS
1. Capillary fluid shift mechanisms
2. Stress relaxation mechanisms

3. LONG ACTING REGULATORY MECHANISMS


They are slow acting. Act over a period of days to years.
a. Direct mechanisms
b. Indirect mechanisms - Involve Renin- Angiotensin system
Aldosterone system