Blood pressure (Hypertension)!

Blood pressure



What is blood pressure?

Bloodpressure is the force exerted by circulating blood on the walls ofblood vessels, and constitutes one of the principal vital signs. Bloodpressure is generated by the heart pumping blood into the arteries andis regulated by the response by the arteries to the flow of blood.





Blood pressure is generated by the heart pumping blood into the arteries and is regulated by the response by the arteries to the flow of blood.
Blood pressure is generated by the heart pumping blood into the arteries and is regulated by the response by the arteries to the flow of blood.

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What is low blood pressure?

Whenthe flow of blood is too low to deliver enough oxygen and nutrients tovital organs such as the brain, heart, and kidney, the organs do notfunction normally and may be permanently damaged.

When blood flow is too low to deliveradequate oxygen to the body's organs, they may not function normallyand may be permanently damaged.




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What is healthy blood pressure?

Whenthe heart beats, it pushes blood through the arteries in the body. Thesystolic blood pressure measures the pressure generated within thearteries when the heart pumps. The diastolic pressure measures theunderlying resting pressure within the artery when the heart iscollecting blood and not pumping. Any blood pressure measurement above120/80 millimeters of mercury is considered elevated.


Systolic blood pressure for healthyadults falls between 90 & 120mm of mercury. Normal diastolic bloodpressure falls between 60 & 80mm of mercury.


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How is blood pressure generated?

Duringrelaxation of the heart (diastole) the left ventricle of the heartfills with blood returning from the lungs. The left ventricle thencontracts and pumps blood into the arteries (systole). The pulse thatwe can feel when we place our fingers over an artery is caused by thecontraction of the left ventricle.

The pulse that we can feel when weplace our fingers over an artery is caused by the contraction of theleft ventricle, pumping blood through the body.



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How is blood pressure determined?

Bloodpressure is determined by the amount of blood pumped by the leftventricle of the heart into the arteries, and the resistance to theflow of blood caused by the walls of the arteries. Generally, bloodpressure tends to be higher if more blood is pumped, or if the arteriesare narrow and stiff. Blood pressure tends to be lower if less blood isbeing pumped, or if the space within the arteries of the body is largerand have less resistance to the flow of blood.

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Blood pressure is determined by thestrength of the heart contraction when it beats, heart valve function,and blood vessel wall tension.



How does the body maintain normal blood pressure?

Thebody has mechanisms to alter or maintain blood pressure by specializednerve cells called baroreceptors. These sensors, found in the largearteries closest to your heart, sense blood pressure and then sendsignals to the heart, the arteries, the veins, and the kidneys thatcause them to make changes that regulate blood pressure. The goal is tomaintain cardiac output, the amount of blood delivered to organs in thebody.


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The body has mechanisms to alter or maintain blood pressure by specialized nerve cells called baroreceptors.






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Baroreceptor signals sent to the heart.

Baroreceptorsignals sent to the heart can speed up and contract more frequently toeject more blood per minute. This response increases the flow of bloodinto the arteries and may increase blood pressure.

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If blood pressure falls, the heart is signaled to beat faster and to try to increase cardiac output.



Baroreceptor signals sent to the veins.

Baroreceptorscan signal veins to expand so more blood can be stored in the veins andless blood returns to the heart for pumping into the arteries. As aresult, the heart pumps less blood per beat, and blood pressure maydecrease. On the other hand, when veins narrow, less blood is stored inthe veins, more blood returns to the heart for pumping into thearteries, and blood pressure increases.

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Baroreceptor signals can trigger veinsto expand or narrow. Narrowing returns more blood to the heart whichmay raise blood pressure.



Baroreceptor signals sent to the arteries.

Whenblood pressure is high, the receptors signal the arteries to expandcreating less resistance to the flow of blood and decrease bloodpressure. When pressure Is low, narrowed arteries create moreresistance and raise blood pressure.
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The arteries can expand and narrow.When blood pressure is low, the receptors signal the arterioles tonarrow and raise blood pressure.



Baroreceptor signals sent to the kidneys.

Thekidney can respond to changes in blood pressure by increasing ordecreasing the amount of urine that is produced. Urine is primarilywater that is removed from the blood. When the kidney makes more urine,the amount (volume) of blood that fills the arteries and veinsdecreases, and this lowers blood pressure. If the kidneys make lessurine, the amount of blood that fills the arteries and veins increasesand this increases blood pressure. Compared with the other mechanismsfor adjusting blood pressure, changes in the production of urine affectblood pressure slowly over hours and days. (The other mechanisms areeffective in seconds.)

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The kidney can respond to receptor changes in blood pressure by increasing or decreasing the amount of urine that is produced.



Is low blood pressure bad for your health?

Peoplewho have lower blood pressures have a lower risk of stroke, kidneydisease, and heart disease. Athletes, people who exercise regularly,people who maintain ideal body weight, and non-smokers tend to havelower blood pressures. Therefore, low blood pressure is desirable aslong as it is not low enough to cause symptoms and potentially damageorgans of the body.

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Lower blood pressure readings areacceptable as long as it is not too low to cause symptoms andpotentially damage the organs of the body.








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What are low blood pressure signs and symptoms?

Iflow blood pressure is the normal state for a patient, then there willbe no symptoms. However, if low blood pressure is symptomatic, then thepatient may feel lightheaded and dizzy, unsteadiness as blood flow tothe brain is decreased. There may be blurring of vision, weakness,confusion, and nausea. Other organs may be involved causing chest pain,shortness of breath, cool, clammy skin, and passing out or fainting.
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If low blood pressure is symptomatic,patients may feel a wide variety of symptoms from dizziness andlightheadedness to shortness of breath and chest pain.


What are the causes of low blood pressure?

Conditionsthat decrease the volume of blood (for example, bleeding, dehydration),reduce cardiac output (for example, heart attack, cardiomyopathy), anddecrease the tension in artery walls may cause low blood pressure.Medication side effects can cause low blood pressure, as can spinalcord injuries.

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Low blood pressure may result from manycauses including decreased blood volume, weakened heart muscle, andloss of artery wall tension.



Neurological causes of low blood pressure.

Thebody requires the central nervous system to be functioning normally tomaintain a normal blood pressure. There is a balance between theadrenalin system and the vagus nerve. If there is overstimulation ofthe vagus nerve, the veins will dilate, not enough blood will return tothe heart and blood pressure may fall. Vasovagal syncope is very commonand often occurs when a noxious stimulus occurs (fainting at the sightof blood or with pain). Sometimes the vagus nerve is stimulated when aperson pushes too hard when urinating or having a bowel movement.

If adrenalin to arteries is blocked, like in a spinal cord injury, thetension in the artery walls is lost and the arteries will dilate, notmaintaining blood pressure.


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Neurologic conditions may be the cause of low blood pressure.



Non-neurological causes of low blood pressure.

Somenon-neurologic conditions that can cause low blood pressure includebleeding, dehydration from vomiting and diarrhea or infections,abnormalities in adrenal gland function, and blood loss.

Pregnancy may cause lower blood pressures as part of normal physiology.

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Bleeding, infections, dehydration,heart disease, and pregnancy are examples of non-neurologicalconditions that may cause low blood pressure.











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Medications may cause of low blood pressure.

Medicationsmay cause low blood pressure. Medicines used to control high bloodpressure (angiotensin receptor blockers, beta blockers, calcium channelblockers, alpha-blockers and diuretics or water pills) can work toowell and cause symptomatic low blood pressure. Other medications maycause low blood pressure as a side effect. Examples include tricyclicanti-depressants [for example, amitriptyline (Elavil)], Parkinson'smedications [for example, levodopa-carbidopa (Sinemet)], and erectiledysfunction therapies [for example, sildenafil (Viagra)].

Alcohol and narcotic pain medications may also cause low blood pressure.


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Taking certain medications may cause low blood pressure.



What other conditions cause low blood pressure?

Septicemiais a severe infection in which bacteria (or other infectious organismssuch as fungi) enter the blood. Commonly the initial infection mayoriginate in the lungs (as pneumonia), bladder (urinary tractInfection), or in the abdomen (diverticulitis). Untreated, the bacteriaenter the bloodstream where they may release toxins and causelife-threatening and profound low blood pressure (septic shock), oftenwith damage to several organs.


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Low blood pressure is a hallmark for septicemia, a situation where the body is subject to an overwhelming infection.



What other conditions cause low blood pressure?

Anaphylaxis(anaphylactic shock) is a potentially fatal allergic reaction tomedications such as antibiotics, foods like peanuts, bee stings (insectstings), or intravenous contrast dye used in medical studies. Theallergic reaction causes the body's immune system to cascade out ofcontrol in response to exposure to an allergic substance. However, thissituation is not common.
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Anaphylaxis is a potentially fatalallergic reaction to items such as penicillin, peanuts, and insectstings which may lead to a severe drop in blood pressure.



How is low blood pressure diagnosed?

Measuringblood pressure, sometimes in both the lying (supine) and standingpositions usually is the first step in diagnosing low blood pressure.In patients with symptomatic low blood pressure, there often is amarked drop in blood pressure upon standing, and patients may evendevelop lightheadedness and feel as If they are going to pass out. Theheart rate may increase as well. Once low blood pressure has beenidentified its cause needs to be found. Sometimes the causes arereadily apparent (for example, trauma with bleeding or a spinal cordInjury, or vasovagal syncope). At other times, the cause may requiretests to determine the source of the problem.
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Postural or orthostatic vital signs maybe taken to uncover low blood pressure. Blood pressure readings aretaken in both the lying (supine) & standing positions.



How is low blood pressure treated?

Patientswith symptoms that are possibly due to low blood pressure should beevaluated by a doctor. Patients who have had a major drop in bloodpressure from their usual levels even without the development ofsymptoms also should be evaluated. Treatment will be based upon thecause of the low blood pressure reading. For example, a person beingtreated for high blood pressure, may need to have their medicationsadjusted. Or for a person with dehydration due to vomiting anddiarrhea, intravenous fluids may be required.
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Treatment of low blood pressure is determined by its cause.







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السلام عليكم ورحمة الله وبركاته


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