Blood Vessels: Structure

and Function.
Prepared By;

Mr. Johny Kutty Joseph

Blood Vessels
There are nearly 100000 km of vessels carrying
blood through the body.
The blood vessels are developed through the
process of angiogenesis during embryonic stage
through the life span.
There are mainly 5 types of vessels such as;
Arteries: carry blood AWAY from the heart
Arterioles: smallest arteries
Capillaries: site of exchange in tissues
Venules: smallest veins
Veins: carry blood TO the heart

Arteries
The arteries are vessels that carry blood away
from the heart.
Elastic arteries: Largest
arteries
and
largest
diameter
but
walls
relatively thin. Function as
pressure reservoir. Walls
can stretch and recoil to
propel
blood
while
ventricles relaxing. Also
known as conducting
arteries conduct blood
to medium-sized arteries.

Arteries
2. Muscular arteries: Tunica media contains more

smooth muscle and fewer elastic fibers than elastic

arteries. Walls relatively thick. Capable of great
vasoconstriction/ vasodilatation to adjust rate of
blood flow. Also called distributing arteries.
3. Arterioles: Also called resistance vessels. They are
smallest arteries. They create resistance against
blood flow to maintain blood pressure. Met-arteriole
is the term used for the connecting vessel of
arterioles and capillaries. Sympathetic innervations
and local chemical mediators can alter diameter
and thus blood flow, resistance, vasoconstriction
and pressure is maintained.

Anastamosis and End Arteries

Some Arteries that form links within main
arteries is called as anastamosis. It is seen in
Palms, Soles, Brain etc. Anastamotic arteries
provide Collateral Circulation.
Some arteries do not form anastamosis hence
called as End Arteries. No Anastamosis beyond
distal anastamosis. Occlusion of the end artery
causes death of distal tissues as there is no
alternate supply.

Capillaries

They are the microscopic vessels that carry blood

from arterioles to venules; and this is called as
microcirculation.
The diameter is just large enough for a red blood cell.
The walls consist of tunica intima only (i.e. layer of
endothelium).
Substances pass through just one layer of endothelial
cells and basement membrane.
Although they are tiny around a billion are present in
body.
It forms the capillary bed for exchange of materials
across the plasma membrane.

Capillary Beds

Capillaries

True Capillaries receive blood from arterioles.

Capillaries are classified into three types based on
ease of passage of substances and structural
differences.
1.Continuous capillaries: have a continuous
endothelial cells with small opening in between called
as intercellular clefts. These are found in skeletal
muscles and lungs.

Capillaries
capillaries: they

1. Fenestrated
also have intercellular clefts but
in addition they have small
holes or fenestrations through
the plasma membrane of the
endothelial cells. They are
found in kidneys and intestines.

2. Sinusoid capillaries: they have

wider lumen and incomplete
endothelial cells. They have
large fenestrations too. They
are found in bone marrow and
liver which helps in the transfer
of blood cells from intravascular
space to surrounding tissues.

Veins & Venules

It is a vessel carrying blood towards the heart.

The first venous structure are called venules similar
to capillaries.
The movement of WBC and Platelets to the site of
injury takes place from venules.
Venules empty the blood to large veins.
Veins possess the great capacity to stretch to
accommodate all blood emptied to heart.
Venous sinus is the term used to indicate large veins
such as coronary sinuses and thy have thin
endothelium.
It has valves which aids in venous return by
preventing backflow

Venous Return
Factors aiding
return:

venous

Large lumen
which
offers little resistance.
Valves
to
prevent
backflow
Muscular pump
skeletal muscles push
blood toward the heart.
Respiratory pump
pressure gradient sucks
blood into thorax.

The Vessels
Functions:
Distribution of blood
Exchange of materials with tissues
Return of blood to the heart
Structure: All the blood vessels are made of four
types of tissues such as endothelial tissue,
collagen fibers, elastic fibers, and smooth muscle
tissue.
Endothelial tissue: It is a line of simple squamous
epithelial cells. They provide smooth luminal
surface and promotes blood flow preventing
coagulation.

The Vessels
Collagen fibers: They are the fibrous tissues
which are flexible but not elastic. They help in
maintenance of shape and size of vessels.
Elastic Fibers: Composed of elastin protein
fibers and forms a rubber like structure which is
capable of stretching under certain conditions.
They are arranged in circular pattern and they
recoil after distension.
Smooth Muscle Tissue: Found in the walls and
are involuntary muscles which helps in
maintaining the tension during stretching.

General Structure of Blood Vessels

Arteries and veins are
composed of three tunics
or coatings such as
tunica interna
tunica media
tunica externa
They are arranged in
sequence from outside to
inside with a lumen inside.
The general structure is
different in thickness and
layer from vessel to vessel.

General Structure

Outer Layer: Tunica Externa

The walls of the large arteries and veins have

three layers.
It is also called tunica adventitia.
It is made of strong flexible elastic and collagen
fibers.
The collagen fibers extend to external structures
to hold it open.
This is the thickest layer of all three.

Middle Layer: Tunica Media

Layer of smooth muscle - circular arrangement
contains elastin.
Depending on bodys needs lumen is
narrowed
(vasoconstriction)
or
widened
(vasodilatation)
Smooth muscle regulates diameter of lumen
The autonomic nerve supply called as nervi
vasorum and the blood supply to vessels is
called vasa vasorum: it connects to the midle
layer

Inner Layer:Tunica Intima

innermost smooth layer
simple squamous epithelium
continuous with the endocardial layer.
present in all vessels, Inner lining in direct,
contact with blood
In arteries it provides complete smooth surface
whereas in veins it forms valvular structures to
maintain on way of blood flow.

Control of Blood Vessels

Responsibility of the vaso-motor centre in the
medulla oblongata.
Change the diameter of the lumen of the blood
vessel.
Medium and small arteries have more muscle
fibres
Large vessels are mostly elastic.
Small arteries and Arterioles respond to nerve
stimuli
Large vessels respond to the amount of blood in
them.

Various Circulations?
Systemic Circulation
Pulmonary Circulation
Portal Circulation
Lymphatic Circulation
Coronary Circulation

CIRCULATORY ROUTES
The term circulation suggests the flow of
blood through vessels arranged in body.
The Systemic circulation conducts blood floe
from the heart (left ventricle) to all parts of the
body and back to the heart (right atrium)
The pulmonary circulation starts from right
ventricle to the pulmonary trunk and then to
lungs for gas exchange and delivers
oxygenated blood into left atrium.
Portal circulation is the blood flow of liver
which is different from other organs since two
capillary beds (liver & intestine=portal vein)
are passed before reaching vein where as only
one capillary bed is present for other organs.

CIRCULATORY ROUTES
Vascular anastamosis is the term used to
describe a second type of circulation where
there is direct connection between arteries to
arteries and veins to veins without passing
through capillary beds.
Coronary arteries is the blood supply of the
heart. It promotes collateral circulations.
Absence of this can create coronary block
where bypass surgery may be required.
Venous
anastamosis
promotes
multiple
drainage facility especially in deep veins and
lack of this can create DVT(deep vein
thrombosis)

Capillary Circulation and Gas

Exchange in the capillary

Arteries, Veins, and

Capillaries
Arteries-blood away from the heart, smooth
muscles, diameter able to be regulated
Veins-blood back to the heart, little
elasticity, contain valves
Capillaries-functional unit of the circulatory
system, all exchanges occur within the
capillaries, arterioles, and venules
Small size RBC pass in single file.

Blood Distribution

Largest portion of
blood at rest is in
systemic veins and
venules

Blood reservoir

Venoconstriction
reduces volume of
blood in reservoirs
and allows greater
blood volume to flow
where needed

What moves across in

Capillaries?
water
proteins
gases
nutrients
hormones
wastes
electrolytes
leukocytes

Blood: Plasma and Cells

Plasma
Water-90%
Electrolytes-inorganic
salts
Proteinsimmunoglobulins,
fibrinogens
Nutrients, metabolic
wastes, respiratory
gases, and hormones

Cellular elements-produced
by pluripotent stem
cells
Erythrocytes-red blood
cells (RBC), oxygen
transport, lack nuclei,
mitochondria, 3-4 months
Platelets-blood clotting,
cell fragments
Leucocytes-white blood
cells, immunity

How materials move in

capillaries?

3 ways to do it
Basic ways are:
1. Filtration
2. Diffusion
3. Diapedesis
Movement is commonly called Bulk
flow

Diffusion

Most important method

Substances move down their concentration gradient

O2 and nutrients from blood to interstitial fluid to body cells

CO2 and wastes move from body cells to interstitial fluid to

blood

Can cross capillary wall through intracellular clefts,

fenestrations or through endothelial cells

Most plasma proteins cannot cross

Except in sinusoids proteins and even blood cells leave
Blood-brain barrier tight junctions limit diffusion

Diffusion
Diffuse across the capillary.
Depends on its chemical nature.
Hydrophobic (or nonpolar or lipidsoluble) have no problem diffusing.
Crossing right through the endothelial
cells.
Do not see the membranes of the
endothelial cells as barriers - lipidsoluble material can pass right
through them.
Eg: Oxygen Carbondioxide and
Hormones

Hydrophilic Substances : Through

Endothelial Slits
Eg: Nutrients

Filtration
Substances are dissolved in the blood plasma.
Capillaries can leak out material at the junctions
between endothelial cells.
Questions are
1. What direction does the fluid flow across the
capillary?
2. Why does the fluid escape from the capillary?

Direction of Fluid escape

The capillaries are porous
Hence the fluid inside and outside
are in contact (Plasma and
ECF or Insterstitial Fluid)
Exchange depends of the
Pressures of the fluids
Two main pressures on the
fluids.
One is osmotic pressure (shown
here using blue arrows for the
water).
Other is the blood pressure on
the capillary walls (shown
here using red arrows for
blood).

Osmotic Pressure
Twosolutionsofdiffsolute
concentrations.
WaterleavestotheHypertonic
sidepushingitswayintothe
hypertonicsolution.
This"pushing"istheosmotic
pressure.
Itturnsoutthatthebloodis
hypertonictothe
extracellularfluid.Sowater
isalwaystryingtopushits
wayintothebloodvesseldue
toosmoticpressure.The
pressureduetoosmosis
remainsconstantacrossthe
entirecapillary.

Osmotic Pressure
Thebloodcontainsarelativelyhigh
concentrationofproteins(7to9
g/100mL)
theselargemoleculescannoteasily
passthroughthecapillarywalls.
Thesamekindsofproteinsalsooccur
inthetissuefluids,butinmuch
lowerconcentration(about2g/100
mL).
Becauseofthedifferentprotein
concentrationsonthetwosidesof
thecapillarywall,thebloodand
tissuefluidshavedifferent
osmoticpressures.
Normally,theosmoticpressureofthe
bloodisabout22mmHghigherthan
thatofthetissuefluid.
Thus,thebloodishypertonictothe
tissuefluid,withtheresultthat
watertendstomoveintothe
capillariesfromthetissuefluid
byosmosis.

Blood Pressure
The blood pressure, or
hydrostatic pressure of the
blood (a.k.a., outward
hydrostatic pressure) is an
outward pressure.
Due to Blood pressing on the
walls as it runs through the
capillary from arteriole to
venule ends.
Not a constant pressure it
keeps on falling asiot reaches
the venule end.

Net Effect

Hydrostatic pressure of the blood

pushing out is greater at the
arteriole end than the osmotic
pressure pushing in.
So: Net pressure on all fluids at
the arteriole side is outward.
Yet, at the venule side, the
hydrostatic pressure of the
blood pushing out is less than
the osmotic pressure pushing
in.
So: Net pressure on all fluids at
the venule side is inward.
In Summary : More fluid ends up
being filtered out of the
capillary than into it.

Net:Effect
Hydrostatic blood
pressure, exerted by
the heart, tends to
force water out of the
capillaries.
Osmotic pressure,
reflecting a difference
in protein
concentrations, tends
to draw water into the
capillaries.

Magnitude of Opposing forces:

Arterial end:

Hydrostatic pressure differential is 32

mm Hg
Osmotic pressure differential is 22 mm
Hg.

Net pressure of 10 mm Hg tending to

force water out of the capillaries.

Magnitude of Opposing
forces:
Venuous end
Hydrostatic pressure
differential has fallen to 15
mm Hg
Osmotic pressure
differential is still 22 mm Hg
Net pressure of at least 7
mm Hg tending to draw
water into the capillaries.

Starlings Law

Nearly as much reabsorbed as filtered

At the arterial end, net outward pressure of 10

mmHg and fluid leaves capillary (filtration)
At the venous end, fluid moves in
(reabsoprtion) due to -7 mmHg
On average, about 85% of fluid filtered in
reabsorpbed
Excess enters lymphatic capillaries (about 3 L/
day) to be eventually returned to blood

Slightly more filtration of fluid into the tissue

spaces than is reabsorbed. About ninetenths of the fluid that has filtered out is
reabsorbed; the other one-tenth flows
into lymph vessels.
The lymphatic system is an accessory route
by which fluids can flow from the tissue
spaces into the blood.
Lymphatic vessels can carry proteins and
large particles away from the tissue
spaces, neither of which can be
absorbed directly into the blood
capillary.
The removal of proteins from the tissue
spaces is an absolutely essential
function, without which we would die
within about 24 hours.

Lymph

Lymph - Edema
Imbalance of Hydrostatic and Osmotic pressures in the
capillaries.
A 20 mm rise in capillary pressure causes an increase
net filtration pressure which results in 68 times as
much net filtration of fluid into the tissue spaces as
normal.
Require 68 times the normal flow of fluid into the
lymphatic system, too much for it to handle.
Accumulates in the tissues, and an abnormal swelling,
called edema, occurs.

Elephatiasis
Elephantiasis is a condition of extreme
edema that occurs when lymph vessels
become blocked by filarial worms. Here
the left leg is swollen with the fluids
accumulated in the tissues as a result
of the blockage.

Low Capillary Pressure

Conversely, if capillary pressure is very
low, net reabsorption into the blood
increases at the expense of the tissue
fluid volume.
Increasing or decreasing the protein
concentration in the blood also
profoundly affects capillary exchange.

Bulk Flow

Passive process in which large numbers of ions,

molecules, or particles in a fluid move together in
the same direction
Based on pressure gradient
Diffusion is more important for solute exchange
Bulk flow more important for regulation of relative
volumes of blood and interstitial fluid
Filtration from capillaries into interstitial fluid
Reabsorption from interstitial fluid into
capillaries

Diapaedisis / Transcytosis
WBCorLipids
toobigforfiltrationordiffusion.
squeezeoutoftheendothelialslitsin
capillaries.

Smallquantityofmaterialonly

Substancesinbloodplasmabecomeenclosedwithin
pinocytoticvessiclesthatenterendothelial
cellsbyendocytosisandleavebyexocytosis

Importantmainlyforlarge,lipidinsoluble
moleculesthatcannotcrosscapillarywallsany
otherway

Theleukocyteshavetocrawlandsqueezetosneak
throughthistinylittlegap.

Gas Exchange
O2 and CO2 exchange between
person and environment
Air dissolved in water is the
source of O2
Respiratory surface: large,
moist, permeable, vascularized
Body surface, lungs, tracheal
systems.
Capillary system on the other
side

Internal Respiration
Exchange is through
diffusion, dependent upon
partial pressure of O2 and
CO2
Down Concentration
Gradient
Oxygen rich arterial blood
down to tissue with lower
oxygen due to tissue
consumption

Internal Respiration
Oxyhaemoglobin is unstable
Delivers the Oxygen
CO 2 Diffuses into the venous side of
the capillary due to conc gradient.

Carbon dioxide
Transport
Dissolved in the
plasma of Blood 7%
Bound with Sodium
as Bicarbonate 70%
Remainder in
combination with Hb 23%

Oxygen and Carbon Dioxide

Transport
Oxygen Transport
Utilizes respiratory
pigments: hemocyanin
in some invertebrates,
hemoglobin in most
vertebrates
Hemoglobin exhibits
cooperativity
Hb affinity for O2 altered
by pH (Bohr Shift)

CO2 Transport
Transported in three
forms:
1. Dissolved in
plasma (7%)
2. Bound to Hb (23%)
3. Bicarbonate ion in
the plasma (70%)

In summary

Dynamics

of Capillary Exchange

Hemodynamics: Factors affecting

blood flow

Blood flow volume of blood that flows through any

tissue in a given period of time (in mL/min)
Total blood flow is cardiac output (CO)

Volume of blood that circulates through systemic (or

pulmonary) blood vessels each minute

CO = heart rate (HR) x stroke volume (SV)

Distribution of CO depends on

Pressure differences that drive blood through tissue

Flows from higher to lower pressure

Resistance to blood flow in specific blood vessels

Higher resistance means smaller blood flow

Copyright 2009, John
Wiley & Sons, Inc.

Blood Pressure

Contraction of ventricles
generates blood pressure
Systolic BP highest
pressure attained in
arteries during systole
Diastolic BP lowest
arterial pressure during
diastole
Pressure falls progressively
with distance from left
ventricle
Blood pressure also
depends on total volume of
blood

Copyright 2009, John

Wiley & Sons, Inc.

Vascular resistance
Opposition to blood flow due to friction
between blood and walls of blood vessels
Depends on

Size of lumen vasoconstriction means lumen

smaller meaning greater resistance
Blood viscosity ratio of RBCs to plasma and protein
concentration, higher viscosity means higher
resistance
Total blood vessel length resistance directly
proportional to length of vessel

400 miles of additional blood vessels for each 2.2lb. of fat

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Wiley & Sons, Inc.

Venous return

Volume of blood flowing back to heart through

systemic veins
Occurs due to pressure generated by
constriction of left ventricle
Small pressure difference from venule (16
mmHg) to right ventricle (0 mmHg) sufficient

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Wiley & Sons, Inc.

Skeletal Muscle Pump

2 other mechanisms

Skeletal muscle pump milks blood in 1 direction

due to valves
Respiratory pump due to pressure changes in
thoracic and abdominal cavities

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Wiley & Sons, Inc.

Proximal
valve

Distal
valve

Copyright 2009, John

Wiley & Sons, Inc.

Velocity of blood flow

Speed in cm/sec in inversely related to crosssectional area

Velocity is slowest where total cross sectional area
is greatest
Blood flow becomes slower farther from the heart
Slowest in capillaries
Aids in exchange
Circulation time time required for a drop of blood
to pass from right atrium, through pulmonary and
systemic circulation and back to right atrium

Normally 1 minute at rest

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Wiley & Sons, Inc.

Relationship between Velocity of Blood Flow

and Total Cross-sectioned area in Different
Types of Blood Vessels

Copyright 2009, John

Wiley & Sons, Inc.

Control of blood pressure and blood

flow

Interconnected negative feedback

systems control blood pressure by
adjusting heart rate, stroke volume,
systemic vascular resistance, and blood
volume
Some act faster that others
Some shorter- or longer-term

Copyright 2009, John

Wiley & Sons, Inc.

Role of cardiovascular center (CV)

In medulla oblongata
Helps regulate heart rate and stroke volume
Also controls neural, hormonal, and local negative
feedback systems that regulate blood pressure and
blood flow to specific tissues
Groups of neurons regulate heart rate, contractility
of ventricles, and blood vessel diameter
Cardiostimulatory and cardioinhibitory centers
Vasomotor center control blood vessel diameter
Receives input from both higher brain regions and
sensory receptors
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Wiley & Sons, Inc.

CV Center

Copyright 2009, John

Wiley & Sons, Inc.

3 main types of sensory receptors

Proprioceptors monitor movements of joints and

muscles to provide input during physical activity
Baroreceptors monitor pressure changes and
stretch in blood vessel walls
Chemoreceptors monitor concentration of
various chemicals in the blood

Output from CV flows along neurons of ANS

Sympathetic (stimulatory) opposes

parasympathetic (inhibitory)
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Wiley & Sons, Inc.

Neural regulation of blood pressure

Negative feedback loops from 2 types of
reflexes
Baroreceptor reflexes

Pressure-sensitive receptors in internal carotid

arteries and other large arteries in neck and chest

Carotid sinus reflex helps regulate blood pressure in brain

Aortic reflex regulates systemic blood pressure

When blood pressure falls, baroreceptors stretched

less, slower rate of impulses to CV
CV decreases parasympathetic stimulation and
increases sympathetic stimulation
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Wiley & Sons, Inc.

Neural regulation of blood

pressure
Chemoreceptor reflexes

Receptors located close to baroreceptors of carotid

sinus (carotid bodies) and aortic arch (aortic
bodies)
Detect hypoxia (low O2), hypercapnia (high CO2),
acidosis (high H+) and send signals to CV
CV increases sympathetic stimulation to arterioles
and veins, producing vasoconstriction and an
increase in blood pressure
Receptors also provide input to respiratory center
to adjust breathing rate
Copyright 2009, John
Wiley & Sons, Inc.

Copyright 2009, John

Wiley & Sons, Inc.

Copyright 2009, John

Wiley & Sons, Inc.

Hormonal regulation of blood

pressure

Renin-angiotensin-aldosterone (RAA)
system

Renin (released by kidney when blood volume

falls or blood flow decreases) and angiotensin
converting enzyme (ACE) act on substrates to
produce active hormone angiotensin II

Raises BP by vasoconstriction and secretion of

aldosterone (increases water reabsorption in
kidneys to raise blood volume and pressure)

Copyright 2009, John

Wiley & Sons, Inc.

Hormonal regulation of blood

pressure

Epinephrine and norepinephrine

Adrenal medulla releases in response to sympathetic

stimulation
Increase cardiac output by increasing rate and force of
heart contractions

Antidiuretic hormone (ADH) or vasopressin

Produced by hypothalamus, released by posterior

pituitary
Response to dehydration or decreased blood volume
Causes vasoconstriction which increases blood
pressure
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Wiley & Sons, Inc.

Atrial natriuretic peptide (ANP)

Released by cells of atria

Lowers blood pressure by causing vasodilation
and promoting loss of salt and water in urine
Reduces blood volume

Copyright 2009, John

Wiley & Sons, Inc.

Autoregulation of blood pressure

Ability of tissue to automatically adjust its blood
flow to match metabolic demands
Demand of O2 and nutrients can rise tenfold
during exercise in heart and skeletal muscles
Also controls regional blood flow in the brain
during different mental and physical activities
2 general types of stimuli

Physical temperature changes, myogenic response

Vasodilating and vasoconstricting chemicals alter
blood vessel diameter
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Wiley & Sons, Inc.

Circulation

Important difference between pulmonary

and systemic circulation in autoregulatory
response

Systemic blood vessel walls dilate in response

to low O2 to increase O2 delivery

Walls of pulmonary blood vessels constrict

under low O2 to ensure most blood flows to
better ventilated areas of lung
Copyright 2009, John
Wiley & Sons, Inc.

Blood Pressure
Force exerted by the blood on the walls of the blood vessels.
Due to discharge of blood from the LV during Systole into an
already full Aorta.
During LV Systole pressure in the arterial system is 120 mm Hg
or 16 kPa.
During complete diastole, the heart is resting, the presseure within
the arteries is called Diastolic Blood pressure. 80 mm of Hg or
11 kPa.
The difference is the Pulse Pressure
Vary with time, Age, Gender,
Measured with a Sphygmomanometer / Blood Pressur apparatus

Blood pressure
Elasticity of the Arterial walls result in the blood
forward flow.
The distention and recoil occurs through out the
arterial System.
Systemkic Arterial Blood Pressure is essential for
substance to flow in and out of organs
Control of BP is essential for Homeastasis.

Blood pressure
Blood flow is generally equal to cardiac output
Blood flow affected by pressure and resistance
Resistance depends on size of blood vessel and
thickness (viscosity) of blood
Thus :
Blood Pressure = CO X Peripheral Resistance

Blood pressure is highest in large arteries

will rise and fall as heart pumps
highest with ventricular systole
lowest with ventricular diastole
pulse pressure is the difference between
the two
Resistance is highest in capillaries

Main Control

More cells

constriction of blood
vessel walls

Control of blood pressure

Two way control
Short Term:
Baro / Chemo and Hormones
Long Term :
Via Kidneys : Renin / Angiotensin /
Alsosterone Mechanisms

Baro
Receptor
Control

Baro Receptor Control / Sympathetic

Control of blood pressure

Chemoreceptor control

Long term regulation of blood flow (hormones)

If blood pressure is too low:
ADH (antidiuretic hormone) promotes water
retention
Angiotensin II- in response to renin
signal (renin) produced by kidney- why?
drop in blood pressure
stimulation by sympathetic nervous
system
sodium levels too low

What happens?
vasoconstriction (by angiotensin II)
what will that do to blood pressure?
ADH is secreted
aldosterone is secreted
EPO (erythropoietin) secreted by kidneys
if blood volume is too low
ANP secreted if blood pressure is too
HIGH

What is hypertension?
Arterial pressure is too high
Sometimes cause is unknown, or is secondary
to disease
Variety of causes/ risk factors are known
sedentary lifestyle
smoking
obesity
diet (excess sodium; cholesterol; calories
in general)
stress
arteriosclerosis
genetic factors

Consequences?
heart has to work harder; left ventricle
enlarges
atherosclerosis may affect coronary
arteries as well (which have to work harder
anyway) heart disease
deficient blood supply to other parts of
body
damage to blood vessels accumulates
heart failure

Treatment of high blood pressure

Quit smoking; adjust diet; exercise
Drug therapies- strategies differ
Reduce heart rate
calcium channel blockers
reduce calcium flow into heart
muscle and therefore heart rate
relax smooth muscle lining
coronary arteries
beta blockers (reduce stimulation by
sympathetic nervous system)

Diuretics reduce blood volume

ACE inhibitors interfere with reninangiotensin pathway
Vasodilators (such as nitroglycerin) open up
blood vessels (reduce resistance)
If heart is actually failing, digitalis increases
efficiency of heat muscle
Anti-hypertensive drugs may be taken in
combination

Why is exercise good for the heart?

A trained heart is bigger
pumps blood more efficiently (at a lower
rate)
stroke volume increases (due to stronger
contractions, allowing for lower rate)
other benefits: higher aerobic capacity
(contributing to efficiency)
Note that this takes training!

summary

Blood (arterial) pressure is affected by heart

action, blood volume, peripheral
resistance, and blood viscosity
Inability to regulate blood pressure can
contribute to disease
Arteries and veins have structural characteristics
appropriate to bringing blood to the cells
and then back to the heart
Circulatory system allows for adjustments to
exercise, digestion and other necessary
functions