Blood Pressure (BP) BP is the pressure (force per unit area) exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs BP is the pressure (force per unit area) exerted by circulating blood on the walls of blood vessels, and constitutes one of the principal vital signs The pressure of the circulating blood decreases as it moves away from the heart through arteries and capillaries, and toward the heart through veins The pressure of the circulating blood decreases as it moves away from the heart through arteries and capillaries, and toward the heart through veins

Normal Values Large variation from person to person; arterial pressure also varies in individuals from moment to moment Large variation from person to person; arterial pressure also varies in individuals from moment to moment Average of any given population may have a questionable correlation with its general health Average of any given population may have a questionable correlation with its general health In a study of 100 subjects with no known history of hypertension, an average blood pressure of 112/64 mmHg was found, which is in the normal range In a study of 100 subjects with no known history of hypertension, an average blood pressure of 112/64 mmHg was found, which is in the normal range

Systolic vs. Diastolic For each heartbeat, BP varies between systolic and diastolic pressures For each heartbeat, BP varies between systolic and diastolic pressures Systolic pressure is peak pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are contracting Systolic pressure is peak pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are contracting Diastolic pressure is minimum pressure in the arteries, which occurs near the end of the cardiac cycle when the ventricles are filled with blood Diastolic pressure is minimum pressure in the arteries, which occurs near the end of the cardiac cycle when the ventricles are filled with blood

Physiology BP is affected by diet, exercise, disease, drugs or alcohol, obesity, and excess weight BP is affected by diet, exercise, disease, drugs or alcohol, obesity, and excess weight Some physical factors are: rate of pumping, volume of fluid or blood volume, resistance, and viscosity Some physical factors are: rate of pumping, volume of fluid or blood volume, resistance, and viscosity

Blood Pressure Association “Fighting high blood pressure is the best way to combat stroke and heart disease.” “Fighting high blood pressure is the best way to combat stroke and heart disease.”

High Blood Pressure High BP directly increases the risk of coronary heart disease (which leads to heart attack) and stroke High BP directly increases the risk of coronary heart disease (which leads to heart attack) and stroke High BP can occur in children or adults, but it is more common among adults over age 35 High BP can occur in children or adults, but it is more common among adults over age 35

Pathophysiology: High arterial pressure Arterial hypertension can be an indicator of other problems and may have long- term adverse effects Arterial hypertension can be an indicator of other problems and may have long- term adverse effects Sometimes it can be an acute problem, for example hypertensive emergency Sometimes it can be an acute problem, for example hypertensive emergency Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysms, and is the leading cause of chronic renal failure Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysms, and is the leading cause of chronic renal failure

Regulation The regulation of arterial pressure is not completely understood The regulation of arterial pressure is not completely understood Currently, three mechanisms of regulating arterial pressure have been well- characterized: Baroreceptor reflex, Renin- angiotensin system (RAS), and Aldosterone release Currently, three mechanisms of regulating arterial pressure have been well- characterized: Baroreceptor reflex, Renin- angiotensin system (RAS), and Aldosterone release These different mechanisms are not necessarily independent of each other (indicated by the link between the RAS and Aldosterone release) These different mechanisms are not necessarily independent of each other (indicated by the link between the RAS and Aldosterone release)

High Blood Pressure Affects: Your brain- leading causes of strokes, and can lead to a form of dementia (vascular dementia) Your brain- leading causes of strokes, and can lead to a form of dementia (vascular dementia) Your heart and arteries- severely damages these vessels which can cause heart disease and enlargement of the heart muscle Your heart and arteries- severely damages these vessels which can cause heart disease and enlargement of the heart muscle Your kidneys- can damage your kidney’s ability to remove waste from your blood and to reabsorb valuable nutrients and water from the nephron filtrate (excess water raises your BP). Your kidneys- can damage your kidney’s ability to remove waste from your blood and to reabsorb valuable nutrients and water from the nephron filtrate (excess water raises your BP).

High Blood Pressure Affects: Eyes and limbs- damage the blood vessels in your eyes and limbs, causing sight and mobility problems Eyes and limbs- damage the blood vessels in your eyes and limbs, causing sight and mobility problems Diabetes and blood pressure- Increase risk of having a stroke or heart attack. Diabetes and blood pressure- Increase risk of having a stroke or heart attack. Low blood pressure- Some people have a BP level that is lower than average. Most of the time, this is no cause for concern, but sometimes low BP can cause nausea and fainting Low blood pressure- Some people have a BP level that is lower than average. Most of the time, this is no cause for concern, but sometimes low BP can cause nausea and fainting