| Theme | Hypertension and Hypotension in Patients with Maintenance Dialysis -- Mechanisms and Therapeutic Approach | |
|---|---|---|
| Title | Human blood pressure regulation mechanisms | |
| Publish Date | 2003/02 | |
| Author | Goro Tokudome | Department of Internal Medicine, Division of Nephrology and Hypertension, Jikei University School of Medicine |
| Author | Hideyuki Kobayashi | Department of Internal Medicine, Division of Nephrology and Hypertension, Jikei University School of Medicine |
| Author | Makoto Kondo | Department of Internal Medicine, Division of Nephrology and Hypertension, Jikei University School of Medicine |
| [ Summary ] | Blood pressure regulation is flexible and responsive to local organ perfusion requirements. In the dynamics of blood circulation, the level of blood pressure is dependent on the formula for multiplying the pumping action of the heart (cardiac output; CO) by the tone of the arteries (peripheral resistance; PR). Among all physiological conditions, the regulation of blood pressure is one of the most complex, dependent on the integrated reactions of the cardiovascular, renal, neural and endocrine systems, as well as genetic factors. In normotensive subjects, when blood pressure changes drastically, it is normalized within normal ranges because of interactions in neural systems (the autonomic nerve system) hormonal factors (renin-angiotensin system), and the renal system (pressure-natriuresis curve). Hypertension is a disorder related to the average level at which blood pressure is regulated and is of importance because longterm elevated blood pressure damages many target organs. The renal system specially, plays the most important role in continual maintenance of blood pressure regulation. | |