293 MAY 2008 2 CE CREDITS AST

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Te ri Ju n g e c st c fa fast,Editor s Note This is part. of a review series of short,articles about blood,Additional related topics. include blood basics blood,components blood types,and the blood clotting. c lood pressure is the force of the blood within the vascular system. against the vessel wall The pressure or force is caused by the. contraction of the heart pushing the blood into the arteries and. also by the size of the blood vessel wall resistance. Typically arterial blood pressure is measured In certain situations. however venous blood pressure also may be measured. Blood pressure is measured in millimeters mm of mercury Hg. and is recorded as two numbers in relation to one another the format is. similar to writing a fraction Often when recording blood pressure the. designation mm of Hg is not included as it is understood that this is. the only method used for blood pressure measurement. The systolic when the heart is contracted portion of the blood. pressure is the higher number and is written first The diastolic when. the heart is relaxed portion of the blood pressure is the lower num. ber and is written second with a slash separating the two numbers. systolic diastolic, When the numbers are verbalized the slash is represented with the. word over For example a blood pressure that is written as 120 80 is. spoken or heard as one twenty over eighty,istockphoto Greg Nicholas.
MAY 2008 The Surgical Technologist,293 MAY 2008 2 CE CREDITS. PHYSIOLOGY OF BLOOD PRESSURE,MAINTENANCE,Several negative feedback systems are in place. to help regulate blood pressure and blood flow,to keep the body in balance homeostasis The. body is able to carry out some of these responses,within seconds while other responses may not. be evident for several hours or days,The resultant changes help raise or lower the.
blood pressure as needed All blood pressure,maintenance systems will not be discussed in. this article,Pressure sensors called baroreceptors are. istockphoto Stefan Klein,located within the walls of the arteries and the. heart The baroreceptors sense if the blood pres,sure is normal too high or too low and then send. signals to the regulation centers in the brain to, maintain increase or decrease several physiolog called angiotensin converting enzyme ACE.
ical functions including which is a product of the lining of the capillaries. N Heart rate particularly those found in the lungs. N The intensity of the contractions of the heart Angiotensin II causes four responses that. Contraction or dilation of blood vessels and individually contribute to an increase in blood. The kidneys ability to retain or release fluid pressure The presence of angiotensin II in the. blood causes,Cardiac output to be increased and the blood. Hypertension Consider the numbers5,vessels to constrict Cardiac output is the. High blood pressure precedes 74 of cases of heart failure in the United States amount of blood that is pumped from the. High blood pressure is the second leading cause of chronic kidney failure in the ventricles of the heart in a specified amount. United States of time such as one minute or one hour. High blood pressure causes more visits to doctors than any other condition Cardiac output is calculated by multiply. just a 10 decline in the number of visits would save 450 million each year ing the number of heart beats per minute by. High blood pressure affects circulation creating a higher risk for mental the stroke volume which is the amount of. deterioration and Alzheimer s blood forced from either ventricle the right. High blood pressure and its complications cost the US economy more than ventricle to the pulmonary artery or the left. 100 billion each year ventricle to the aorta with each heart beat. A hormone called aldosterone to be released,by the adrenal cortex which results in an. In addition to controlling the amount of fluid increase in the amount of sodium that is. excreted in the form of urine the kidneys also reabsorbed by the distal convoluted tubules. provide negative feedback that helps regulate of the nephrons of the kidneys A secondary. blood pressure The juxtaglomerular apparatus effect of the sodium reabsorption is water. of the kidneys produces an enzyme called renin reabsorption. when blood pressure is too low A hormone called antidiuretic hormone to. Renin in turn activates a blood protein called be released by the posterior pituitary gland. angiotensinogen which is a product of the liver which directly causes the distal convoluted. and converts it into angiotensin I Angiotensin tubules to absorb more fluid and also causes. I is converted to angiotensin II by an enzyme vasoconstriction. The Surgical Technologist MAY 2008, The thirst center in the hypothalamus to be N o r m a l o p t i m a l b l o o d p r e s s u r e. stimulated and fluid intake to be increased In the year 2000 the American Heart Associa. tion redefined what is considered normal blood, Epinephrine and norepinephrine are hormones pressure Blood pressure is considered normal.
that are released from the adrenal medulla es when it is less than 120 80 mmHg. pecially in times of stress The presence of high Blood pressure within the optimal range is. levels of epinephrine and norepinephrine in the necessary for good cardiovascular health and to. blood increase blood pressure and heart rate reduce an individual s risk of stroke A consistent. The response of the adrenal cortex is part of the ly abnormal repeated over time blood pressure. fight or flight response of the sympathetic ner measurement high or low is an indication of a. vous system problem that may require medical intervention. FACTORS INFLUENCING BLOOD PRESSURE,An individual s blood pressure normally varies. throughout the day and over time These variations, are attributed to age dietary intake including but. not limited to fluids for example sodium intake,may be a factor activity levels cigarette smok. ing alcohol intake hormone levels and periods of,high stress among other influencing factors. Blood pressure is also affected by a number of,medications and medical conditions.
Additionally the strength of the contraction,of the heart muscle the volume of blood within. istockphoto Lisa Fletcher,the vascular system the viscosity thickness of. the blood and vasomotor changes constric,tion or dilation that increase or decrease the. resistance tension of the blood vessel walls also,affect blood pressure Prehyper tension. Normally the arterial wall is soft and elastic in Blood pressure is considered prehypertensive. nature Over time and due to dietary influences when the systolic reading is between 120 139. the walls of the blood vessels may harden caus mmHg and the diastolic reading is 80 89. ing increased resistance to blood flow thus rais mmHg A diagnosis of prehypertension is a. ing blood pressure This condition of hardening warning signal that an individual may be headed. is referred to as arteriosclerosis or if there is a toward hypertension An individual with prehy. buildup of plaque atheroma within the vessel pertension needs careful monitoring and life. it is called atherosclerosis style changes may be recommended. Hyper tension,Hypertension or high blood pressure indicates.
The strong association of high blood,increased pressure within the walls of the blood. pressure with obesity and the marked,vessels Blood pressure is considered hyper. increase in the prevalence of childhood,tensive when the systolic reading is above 140. obesity indicate that both hypertension,mmHg and the diastolic reading is above 90. and prehypertension are becoming a,mmHg Typically both the systolic and diastolic.
significant health issue in the young,pressures are elevated although in some cases. only diastolic pressure may be affected,M AY 2008 The Surgical Technologist. Hold the salt and the condition is referred to as essential. hypertension It is suspected that essential hyper, According to the American Heart Association 8 Americans eat an average of 6 18g tension is caused by genetics caffeine intake. of salt every day far more than the 200 mg that our bodies actually need tobacco smoking obesity sodium intake lack of. exercise strong heart contractions rapid heart,Where s all that extra salt coming from. rate or vasoconstriction, About 75 of it is coming from processed foods like premade spaghetti sauce.
Lifestyle changes and the use of medications,canned foods and prepared mixes. that reduce resistance to blood flow in the arter, Read those food labels ies such as diuretics vasodilators renin inhibi. During your next trip to the grocery store slow down and read the nutritional tors ACE inhibitors and calcium blockers can. information printed on the back of what you re buying lower blood pressure Beta adrenergic blockers. Ingredient words to avoid are useful in controlling the heartbeat. Salt sodium chloride When hypertension is the result of another. Monosodium glutamate may be abbreviated as MSG problem it is referred to as secondary hyperten. Baking soda sodium bicarbonate sion Hypertension may be secondary to diabetes. Baking powder kidney disease toxemia of pregnancy vascular. Disodium phosphate disease and endocrine imbalances Treatment of. Sodium compounds anything with the word sodium in it eg sodium the causative condition usually causes the blood. alginate sodium benzoate and sodium nitrite pressure to return to the normal range. Hypotension, Typically hypertension does not cause any Hypotension or low blood pressure indicates. symptoms which is why it is referred to as the decreased pressure within the walls of the blood. silent killer Some individuals though do expe vessels In most cases low blood pressure is. rience symptoms such as headache dizziness desired However if the blood pressure is too low. and vision problems organs and body tissues may not receive enough. Hypertension is considered a major contrib oxygenated blood and nutrients. uting factor to heart disease and stroke and can If an area of the body does not receive the sub. result in kidney damage nervous system disor stances necessary to sustain the life of the cells. ders and vision difficulties permanent damage or tissue death may result. In approximately 90 95 of individuals with Hypotension is only considered problematic if. hypertension the cause cannot be determined the patient is experiencing symptoms. istockphoto Simon vanDenBerg,istockphoto Serdar Vagci. The Surgical Technologist MAY 2008, Symptoms of low blood pressure include diz Phase I Two initial tapping sounds are heard.
ziness and fainting especially when moving The listener notes the pressure on the gauge and. from a lying or sitting position to a standing posi interprets that number as the systolic blood. tion postural or orthostatic hypotension pressure, Causes of hypotension that produce prob Phase II A soft swishing sound is heard as. lematic symptoms include the administration of the cuff is further deflated and more blood pass. various medications dehydration hemorrhage es through the artery. hypovolemic shock toxic shock psychogenic Phase III Rhythmic tapping sounds are heard. shock vasodilation slow or inadequate heart as the cuff is deflated further This phase is often. contractions and excessive urine production misinterpreted as the systolic blood pressure. Treatment of hypotension includes admin Phase IV The tapping sounds become muf. istration of blood or other intravascular fluids fled and faded as the cuff is further deflated. and use of vasoconstrictors and medications to Phase V Sounds disappear completely The. increase the force and or frequency of the con listener notes the pressure on the gauge and. tractions of the heart interprets that number as the diastolic blood. The following technique is used to measure,More women than men have died. blood pressure manually Remember standard,of cardiovascular diseases every year. precautions require that the caregiver s hands are. since 1984 Cardiovascular disease kills,washed before and after providing patient care. as many women each year as the next, 16 causes of death combined including Secure the necessary equipment sphyg.
breast cancer momanometer and stethoscope or an auto. mated blood pressure machine Use of a,sphygmomanometer and stethoscope will be. BLOOD PRESSURE MEASUREMENT The patient is typically in the sitting or supine. Blood pressure is measured with a sphygmoma position When attempting to diagnose. nometer The sphygmomanometer may be an orthostatic hypotension the blood pressure. automatic electronically controlled device capable may also be measured with the patient. of recording the measurements at specific time standing up. intervals or it may be a manual device that typi, cally requires the additional use of a stethoscope. Women are at particularly high risk3,A manual sphygmomanometer consists of. four main components All of the components Despite the efforts of many health care professionals voluntary health orga. are connected with flexible tubing nizations and policy makers many women as well as many healthcare pro. N Inflatable cuff Available in a variety of sizes fessionals are still unaware that cardiovascular disease is the leading cause of. N Pump Inflates the cuff death among women, N Valve Controls the pressure in the cuff To commemmorate the fifth anniversary of the launch of its Go Red for. of the kidneys produces an enzyme called renin when blood pressure is too low Renin in turn activates a blood protein called angiotensinogen which is a product of the liver and converts it into angiotensin I Angiotensin I is converted to angiotensin II by an enzyme called angiotensin converting enzyme ACE which is a product of the lining of the capillaries particularly those found

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