Dr Saima’s

Blood Pressure
Blood pressure is defined as the pressure exerted by blood on the walls of the arteries. Normal blood
pressure is 120/80 mm of Hg. The top number refers to systolic blood pressure whereas the lower
number refers to diastolic blood pressure.

Systolic Blood Pressure:

Systolic blood pressure refers to the maximum amount of pressure in arteries during contraction of
heart muscles. The normal systolic blood pressure range is 110 to 140 mm of Hg.

Diastolic Blood Pressure:

Diastolic Blood Pressure refers to the minimum amount of pressure exerted by blood on the walls of
arteries in diastole condition. The normal diastolic blood pressure range is 60 to 90 mm of Hg.

Pulse Pressure:
The difference between SBP and DBP is called Pulse Pressure.

120-80=40 mm of Hg

The normal pulse pressure range is 35 to 45 mm of Hg.

Mean Arterial Pressure:

Mean arterial presser is the average pressure calculated.

Mean Arterial Pressure= DBP + 1/3rd of Pulse Pressure

= 80 + 40/3

=93 mm of Hg

Regulation of Blood Pressure:

Blood pressure can vary due to physiological conditions such as ageing, gender, stress, anxiety or meal
can fluctuate the blood pressure.

 The increase in blood pressure with age is mostly associated with structural changes in the
arteries. Atherosclerosis is common in older people too. In some individuals, BP decreases with
ageing. This is mostly as a consequence of illness such as Alzheimer’s & other forms of
dementia.
 Men typically have higher BP than women. This sexual dimorphism is due to the production of
testosterone in males.
 Exercise can alter BP. This alteration depends upon the severity of exercise. Mild exercising
fluctuates neither SBP nor DBP. Moderate exercise increases SBP only while severe exercise
 increases SBP and decreases DBP. This is because exhaustion of muscles leads to accumulation
of lactic acid.

Body systems regulate the fluctuations of BP. There are two systems for regulation of BP.

 Nervous Regulation
 Renin Angiotensin Regulation

Nervous Regulation:
Nervous regulatory system is short term and quick in response. If there’s an alteration in the
BP, the first system that recognizes and alters it is nervous regulatory system. It is also short
term i.e. it adapts to a standard. If alteration is continuous, it gets adapted to the alteration.

The receptors in arteries that sense pressure are called baroreceptors or pressure receptors or
presser receptors. They’re located in the carotid arteries. Their normal set point is 120/80 mm
of Hg. When they identify changes in pressure, they send impulses towards the brain via the 9 th
and 10th cranial nerves.

In medulla and pons, there is a special type of centre present called Vasomotor centre (VMC).
VMC releases two types of discharges under normal conditions.

 Sympathetic discharge
 Parasympathetic discharge

Sympathetic discharge increase heart rate, increases cardiac output, and causes
vasoconstriction. In high BP, sympathetic discharge is inhibited and parasympathetic discharge
is released. Parasympathetic discharge decreases heart rate, decreases cardiac output and
causes vasodilation.

Renin Angiotensin Regulation:

Renin angiotension is a long term regulatory system. If the blood pressure is 40/80 mm of Hg, this
regulatory system causes kidneys to release hormones called Renin. Renin converts Angiotensinogen
that is synthesized by liver to Angiotensin I. Angiotensin I breaks down into Angiotensin II by effect of
angiotensin converting enzyme. Angiotensin II performs two functions. One, it causes vasoconstriction
which increases blood volume. Two, it stimulates adrenal cortex to release Aldosterone. Aldosterone
reabsorbs sodium and water from renal tubules which increases fluid volume. Both these functions
performed by Angiotensin II increases blood pressure. In case of a high BP, inhibition of production of
renin by kidneys takes place. This causes vasodilaton.