COLLEGE OF PHARMACY-UNIVERSIY OF SULAIMANI

1. Blood Pressure Regulation and
Hypertension
UNIVERSITY OF SULAIMANI
COLLEGE OF PHARMACY
2015
Prepared By: Dilan Salam Omer

2. Outline
Introduction
Hypertension type and classification
Prevalence
Regulation and control of blood pressure
Treatment
Lethal Effect
Conclusion
References
2/24/2016 University of sulaimany-college of pharmacy 2

3. 2/24/2016 University of sulaimany-college of pharmacy 3
Introduction
In general regulation of blood pressure is maintenance of arterial circulation
and blood pressure throughout the whole body and as well as inside each organ.
 Hypertension is a sustained elevation of the systemic arterial pressure, due to
increased peripheral resistance and is a very common abnormality in humans It
can be produced by many diseases and causes a number of serious disorders.
 The kidney plays a central role in the regulation of atrial blood pressure by
control extracellular fluid , activity of renin angiotensin and aldosterone system

4. 2/24/2016 University of sulaimany-college of pharmacy 4
 Two main types of hypertension:
1) Primary hypertension, a persistently elevated blood pressure
that cannot be attributed to any identifiable cause, Between 90
and 95% of all cases .
2) Secondary hypertension, which has an identifiable underlying
cause, 5–10% of cases.
Hypertension types and classification

5. 2/24/2016 University of sulaimany-college of pharmacy 5
Hypertension types and classification
 number of deaths that would be
expected from coronary artery
disease ,those with systolic arterial
pressures of between 140 and 149
mm Hg

6. 2/24/2016 University of sulaimany-college of pharmacy 6
Prevalence
 Prevalence of hypertension among adults was
29.0% in 2011–2014 , and increased with age:
18–39, 7.3% but 40–59, 32.2% and 60 and
over, 64.9%.
 Hypertension prevalence was higher among
non-Hispanic black (41.2%) than non-
Hispanic white (28.0%), non-Hispanic Asian
(24.9%), or Hispanic (25.9%) adults.
Age
40-59 Over 60

7. 2/24/2016 University of Sulaimani-college of pharmacy 7
Respond In Seconds
 Respond in seconds
 Respond after many minutes
 Long Term Mechanism
• Baroreceptor reflex
• Chemoreceptor
• Fluid shift
• Renal Control
Regulation of blood pressure

8. Auto regulation
• Myogenic theory through intrinsic stretching
• Metabolic theory through accumulation of metabolites
2/24/2016 University of sulaimany-college of pharmacy 8
The capacity of tissues to regulate their own blood flow
is called autoregulation
Usually by maintaining a constant flow through the blood vessels
By two mechanisms:-
Increased
blood
pressure
Stretching of
blood vessels
vasoconstric
tion

9. 2/24/2016 University of sulaimany-college of pharmacy 9
Role of the Nervous system
 Nervous control is by far the most rapid mechanism
for arterial pressure regulation.
 The best known nervous mechanisms for arterial
pressure control is the baroreceptor reflex.
Baroreceptor
Increased blood
pressure
Stretching of
baroreceptors
Signal
Transmition to
CNS
Sympathetic
Parasympathetic
Decrease blood
pressure

10. The kidneys play an important role in the mechanism of
regulating arterial blood pressure, because it has an
important role in the homeostasis mechanism which is
defined as the balance of fluid intake and output. when the
blood volume increase the arterial blood pressure will also
increase this makes the kidney to excrete this excess volume
to return the normal blood pressure.
2/24/2016 University of sulaimany-college of pharmacy 10
Role of the kidney in regulation

11. 2/24/2016 University of sulaimany-college of pharmacy 11
Role of the kidney in regulation

12. 2/24/2016 University of sulaimany-college of pharmacy 12
• One of the most important functions
of the renin angiotensin system is to
allow a person to eat either very small
or very large amounts of salt without
causing great changes in either
extracellular fluid volume or arterial
pressure.
Role of the kidney in regulation

13. 2/24/2016 University of sulaimany-college of pharmacy 13
Treatment of hypertension
First step, lifestyle modifications that are aimed at increasing physical
activity and weight loss in most patients
Drugs :-
o Vasodilator drugs
o Natriuretic or diuretic drugs
By:-
a) Inhibiting sympathetic nervous
b) Relaxing the smooth muscle
c) Blocking the renin-angiotensin-aldosterone system

14. The lethal effects of hypertension are caused mainly
in three ways:
1. Excess workload on the heart .
2. The high pressure frequently damages a major blood
vessel in the brain, followed by death of major
portions of the brain.
3. High pressure almost always causes injury in the
kidneys.
(Guyton AC. Hall JE.2016 Page232)
2/24/2016 University of sulaimany-college of pharmacy 14
Lethal effects

15. Hypertension is an important public health challenge in world
wide, most individuals with HT are unaware of their condition
and, among those with diagnosed HT, treatment is frequently
inadequate.
The body can control disrupted arterial pressure, and according
to its onset of time to control blood pressure, we have three
types of control which are rapid, intermediate and long term
control and this control can be performed by many systems
including, kidney and nervous system
2/24/2016 University of sulaimany-college of pharmacy 15
Conclusion:

16. We believe that new and innovative approaches must be discovered to
control and cure this disease which includes
Gene therapy
1) By Suppression of a defective gene
2) By Overexpression of a normal gene
2/24/2016 University of sulaimany-college of pharmacy 16
Future perspective

17. 2/24/2016 University of sulaimany-college of pharmacy 17
Acknowledgement
We would like to thank our supervisor Dr.Enas Sabah for her help and
guidance throughout the preparation of this seminar.

18. Guyton AC. Hall JE.2016.Textbook of medical physiology 13th 2016.Chapter19:
Page:234.237,241,242
 Principles of Anatomy and Physiology 13th Ed G. Tortora, B. Derrickson (Wiley, 2012),
Chapter 21, P777, P823
Ganong's_Review of Medical Physiology_24thEd 2012, Chapter32, P595
S. J. Howell , J. W. Sear and P.Foëx ,Hypertension, hypertensive heart disease and perioperative
cardiac risk, Br J Anaesth 2004, 92 (4): 570-583.
Yoon S.S, Fryar CD, Carroll MD. Hypertension prevalence and control among adults United
States, 2011–2014. NCHS data brief, no 220.
2/24/2016 University of sulaimany-college of pharmacy 18
References

19. 2/24/2016 University of sulaimany-college of pharmacy 19
Questions
Thank