Blood Pressure Regulation and Hypertension

UNIVERSITY OF SULAIMANICOLLEGE OF PHARMACY

2015

Prepared By: Dilan Salam Omer

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OutlineIntroductionHypertension type and classificationPrevalenceRegulation and control of blood pressureTreatmentLethal EffectConclusionReferences

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IntroductionIn general regulation of blood pressure is maintenance of arterial circulation and blood pressure throughout the whole body and as well as inside each organ.

Hypertension is a sustained elevation of the systemic arterial pressure, due to increased peripheral resistance and is a very common abnormality in humans It can be produced by many diseases and causes a number of serious disorders.

The kidney plays a central role in the regulation of atrial blood pressure by control extracellular fluid , activity of renin angiotensin and aldosterone system

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Two main types of hypertension:

1) Primary hypertension, a persistently elevated blood pressure that cannot be attributed to any identifiable cause, Between 90 and 95% of all cases .

2) Secondary hypertension, which has an identifiable underlying cause, 5–10% of cases.

Hypertension types and classification

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Hypertension types and classification number of deaths that would

be expected from coronary artery disease ,those with systolic arterial pressures of between 140 and 149 mm Hg

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Prevalence

Prevalence of hypertension among adults was 29.0% in 2011–2014 , and increased with age: 18–39, 7.3% but 40–59, 32.2% and 60 and over, 64.9%.

Hypertension prevalence was higher among non-Hispanic black (41.2%) than non-Hispanic white (28.0%), non-Hispanic Asian (24.9%), or Hispanic (25.9%) adults.

Age

40-59 Over 6018-39

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Respond In Seconds

Respond in seconds

Respond after many minutes

Long Term Mechanism

• Baroreceptor reflex• Chemoreceptor

• Fluid shift

• Renal Control

Regulation of blood pressure

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Auto regulation

• Myogenic theory through intrinsic stretching • Metabolic theory through accumulation of metabolites

The capacity of tissues to regulate their own blood flow is called autoregulation

Usually by maintaining a constant flow through the blood vesselsBy two mechanisms:-

Increased blood pressure

Stretching of blood vessels

vasoconstriction

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Role of the Nervous system

Nervous control is by far the most rapid mechanism for arterial pressure regulation.

The best known nervous mechanisms for arterial pressure control is the baroreceptor reflex.

Baroreceptor

Increased blood pressure

Stretching of baroreceptors

Signal Transmition to CNS

SympatheticParasympathetic Decrease

blood pressure

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The kidneys play an important role in the mechanism of regulating arterial blood pressure, because it has an important role in the homeostasis mechanism which is defined as the balance of fluid intake and output. when the blood volume increase the arterial blood pressure will also increase this makes the kidney to excrete this excess volume to return the normal blood pressure.

Role of the kidney in regulation

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Role of the kidney in regulation

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• One of the most important functions of the renin angiotensin system is to allow a person to eat either very small or very large amounts of salt without causing great changes in either extracellular fluid volume or arterial pressure.

Role of the kidney in regulation

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Treatment of hypertension

First step, lifestyle modifications that are aimed at increasing physical activity and weight loss in most patients

Drugs :- o Vasodilator drugso Natriuretic or diuretic drugs By:-a) Inhibiting sympathetic nervous b) Relaxing the smooth musclec) Blocking the renin-angiotensin-aldosterone system

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The lethal effects of hypertension are caused mainly in three ways:

1. Excess workload on the heart .2. The high pressure frequently damages a

major blood vessel in the brain, followed by death of major portions of the brain.

3. High pressure almost always causes injury in the kidneys.

(Guyton AC. Hall JE.2016 Page232)

Lethal effects

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Hypertension is an important public health challenge in world wide, most individuals with HT are unaware of their condition and, among those with diagnosed HT, treatment is frequently inadequate.

The body can control disrupted arterial pressure, and according to its onset of time to control blood pressure, we have three types of control which are rapid, intermediate and long term control and this control can be performed by many systems including, kidney and nervous system

Conclusion:

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We believe that new and innovative approaches must be discovered to control and cure this disease which includes

Gene therapy 1) By Suppression of a defective gene2) By Overexpression of a normal gene

Future perspective

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Acknowledgement

We would like to thank our supervisor Dr.Enas Sabah for her help and guidance throughout the preparation of this seminar.

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Guyton AC. Hall JE.2016.Textbook of medical physiology 13th 2016.Chapter19: Page:234.237,241,242

Principles of Anatomy and Physiology 13th Ed G. Tortora, B. Derrickson (Wiley, 2012), Chapter 21, P777, P823

Ganong's_Review of Medical Physiology_24thEd 2012, Chapter32, P595 S. J. Howell , J. W. Sear and P.Foëx ,Hypertension, hypertensive heart

disease and perioperative cardiac risk, Br J Anaesth 2004, 92 (4): 570-583.

Yoon S.S, Fryar CD, Carroll MD. Hypertension prevalence and control among adults United States, 2011–2014. NCHS data brief, no 220.

References

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Questions

Thank You