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Control of Blood Pressure and the Distribution of Blood Flow

Published online by Cambridge University Press:  10 March 2009

Hans T. Versmold
Hans T. Versmold
Affiliation:
University of Munich
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Extract

Systemic blood pressure (BP) is the product of cardiac output and total peripheral resistance. Cardiac output is controlled by the heart rate, myocardial contractility, preload, and afterload. Vascular resistance (vascular hindrance × viscosity) is under local autoregulation and general neurohumoral control through sympathetic adrenergic innervation and circulating catecholamines. Sympathetic innovation predominates in organs receivingflowin excess of their metabolic demands (skin, splanchnic organs, kidney), while innervation is poor and autoregulation predominates in the brain and heart. The distribution of blood flow depends on the relative resistances of the organ circulations. During stress (hypoxia, low cardiac output), a raise in adrenergic tone and in circulating catecholamines leads to preferential vasoconstriction in highly innervated organs, so that blood flow is directed to the brain and heart. Catecholamines also control the levels of the vasoconstrictors renin, angiotensin II, and vasopressin. These general principles also apply to the neonate.

Type
Neonatal Disorders of Circulation
Information
International Journal of Technology Assessment in Health Care , Volume 7 , Supplement S1 , January 1991 , pp. 79 - 84
Copyright
Copyright © Cambridge University Press 1991

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