Question
What is blood pressure? How is it measured? Explain factors affecting blood pressure.

Answer

1. Blood pressure:

  1. The pressure exerted by blood on the wall of the blood vessels is called blood pressure. Pressure exerted by blood on the wall of arterial wall is arterial blood pressure. Blood pressure is described in two terms viz. systolic blood pressure and diastolic blood pressure.
  2. Systolic blood pressure is the pressure exerted on arterial wall during ventricular contraction (systole). For a normal healthy adult the average value is 120 mmHg.
  3. Diastolic blood pressure is the pressure on arterial wall during ventricular relaxation (diastole). For a normal healthy adult it is 80 mmHg.
  4. B. E = SP/DP = 120/80 mmHg. Blood pressure is normally written as 120/80 mmHg. Difference between systolic and diastolic pressure is called pulse pressure normally, it is 40 mmHg.

2. Measurement of blood pressure:

  1. Blood pressure is measured with the help of an instrument called sphygmomanometer.
  2. The instrument consists of inflatable rubber bag cuff covered by a cotton cloth. It is connected with the help of tubes to a mercury manometer on one side and a rubber bulb on the other side.
  3. During measurement, the person is asked to lie in a sleeping position. The instrument is placed at the level of heart and the cuff is tightly wrapped around upper arm.
  4. The cuff is inflated till the brachial artery is blocked due to external pressure. Then pressure in the cuff is slowly lowered till the first pulsatile sound is produced. At this moment, pressure indicated in manometer is systolic pressure. Sounds heard during this measurement of blood pressure are called as Korotkoff sounds.
  5. Pressure in the cuff is further lowered till any pulsatile sound cannot be heard due to smooth blood flow. At this moment, pressure indicated in manometer is diastolic pressure an optimal blood pressure (normal) level reads 120/80 mmHg.

3. Factors affecting blood pressure:

  1. Cardiac output : Normal cardiac output is 5 lit/min. Increase in cardiac output increases systolic pressure.
  2. Peripheral resistance : Peripheral resistance depends upon the diameter of blood vessels. Decrease in diameter of arterioles and capillaries under the effect of vasopressin cause increase in peripheral resistance and thereby increase in blood pressure.
  3. Blood volume : Loss of blood in accidents decreases blood volume and thus cause decrease in blood pressure.
  4. Viscosity of blood : Blood pressure is directly proportional to viscosity of blood.
  5. Age : Blood pressure increases with age due to increase in inelasticity of blood vessels.
  6. Venous return : Amount of blood brought to the heart via the veins per unit time is called the venous return and it is directly proportional to blood pressure.
  7. Length and diameter of blood vessels : Blood pressure is directly proportional to the total length of the blood vessel. Blood pressure can also be affected by vasoconstriction or vasodilation.
  8. Gender : Females have slightly lower BP than males of her age before menopause. However, the risk of high B. P increases in the females after menopause sets in.

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