Cardiovascular System II. How do we measure blood pressure ?
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Transcript of Cardiovascular System II. How do we measure blood pressure ?
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CardiovascularCardiovascularSystem IISystem II
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How do we measure blood pressure ?
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Stroke volume (and hence, blood
pressure) are strongly influenced by the EDV
The regulation of blood pressure
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The baroreceptor reflex
The regulation of blood pressure
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Hypertension
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Where to draw the limit of “normality” ?
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120 140 160 180
Usual BP (mmHg)
Age 80-89
Age 70-79
Age 60-69
Age 50-59
Age 40-49
Relationship between BP and CV riskMetaanalysis of more than 60 observational studies
Lancet 2002; 360: 1903–13
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System/organ Impact of HTCNS Stroke, dementia
Myocardium Left ventricular hypertrophy
Hypertensive nephropathyKidney
Hypertensive retinopathyEye
Via heart failureAll body systems
Impact of chronic hypertension on body systems
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Demographic
Cardiac
HTA
SexAge
Genetic
Angiotensinogen gene
Hyperaldosteronism
Cardiac output
Sodium retentio
nCaloric intake /
overweight
Renal
Gastrointestinal
Psychological
Stress
Central Nervous System
Sympathetic
hyperactivity
Vascular
Smooth muscle insulin sensitivity
Endothelial function
Why do some people develop hypertension while others don’t ?
Factors involved:
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Atherosclerosis
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Normal histology of the arterial wall
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Infiltration of lipoproteins and
monocytes
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Cell proliferation and differentiation in the
wall
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Formation of “cap” and “shoulders”
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Rupture and thrombosis
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Atherosclerosis
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World Deaths in millions
% of deaths
Coronary heart disease 7.20 12.2
Stroke and other cerebrovascular diseases
5.71 9.7
Lower respiratory infections 4.18 7.1
Chronic obstructive pulmonary disease
3.02 5.1
Diarrheal diseases 2.16 3.7
HIV/AIDS 2.04 3.5
Tuberculosis 1.46 2.5
Trachea, bronchus, lung cancers 1.32 2.3
Road traffic accidents 1.27 2.2
Prematurity and low birth weight 1.18 2.0
Top 10 world causes of death