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Blood pressure is the pressure of the blood against the blood vessel walls as blood flows through the vessels.
The heart beats about 60 to 70 times a minute. With each beat as the heart contracts, a surge of blood is pumped from the heart into the arteries. The pressure in the artery walls during this surge is measured as the systolic blood pressure (a higher number). Between beats, the heart is relaxed and there is much less pressure on the artery walls. This is measured as the diastolic blood pressure (a lower number). Blood pressure is given as two numbers written as 120/80 mm Hg and is measured with a device called a sphygmomanometer in millimeters (mm) of mercury (Hg). The pressure depends on the amount of blood pumped through the heart in addition to the resistance and elasticity of the blood vessels to the amount of blood flowing.
Blood pressure is necessary to sustain life. It continuously forces blood carrying oxygen and nutrients from the heart to the organs and tissues of the body. Blood pressure levels can go up or down in the course of a day depending on activity and stress levels, medications, or diet.
A person's blood pressure is determined by the contraction of the heart's ventricles, which pump blood into the aorta and subsequently throughout the body. The normal adult blood pressure has a systolic number of 120 and a diastolic number of 80. Systolic pressure is taken when the heart contracts; diastolic pressure is taken when the heart is relaxed.
Normally, about 5.5 quarts (5.25 liters) of blood goes through the heart and blood vessels each minute, an amount called cardiac output. The body is dependent on its volume of blood to maintain blood pressure. If a person experiences heavy blood loss, blood pressure will plunge. Similarly, an increase in blood volume, in cases like water retention, will cause blood pressure to rise.
The brain's medulla contains a cluster of nerves, called the cardiovascular center, that control heart rate, the contraction of the ventricles, and blood vessel diameter. Sensory receptors monitor the stretching of blood vessel walls. During exercise, the heart rate rises and the ventricles contract more forcefully. The cardiovascular center then monitors the dilation (expansion) or constriction of peripheral blood vessels. For example, the blood vessels to organs directly involved the exercise will expand. Blood flow to skeletal muscles may increase by a factor of 10 and that to the heart and skin can triple. Simultaneously, constriction will occur in the blood vessels of the digestive system.
The sensory receptors in the walls of blood vessels continually monitor blood pressure. When the receptors
|Classification of blood pressure (BP)|
|SOURCE: Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.|
|Category||Range (mm Hg)||Recommendation|
|Normal BP||Systolic <140; diastolic <85||Recheck in 2 years|
|High-normal BP||Diastolic 85–89||Recheck in 1 year|
|Mild hypertension||Diastolic 90–104||Confirm within 2 months|
|Moderate hypertension||Diastolic 105–114||Evaluate within 1 month|
|Severe hypertension||Diastolic [.greaterequal] 115||Evaluate immediately or within 1 week|
|Borderline isolated systolic hypertension||Systolic 140–159; diastolic <90||Confirm within 2 months|
|Isolated systolic hypertension||Systolic [.greaterequal] 160; diastolic <90||Confirm within 2 months|
detect an increase in aortic pressure, for example, the cardiovascular center directs the lowering of the heart rate and the stretching of blood vessels, which decreases the blood pressure. A decrease in blood pressure causes an increased heart rate and vasoconstriction.
As people age, the blood vessels become less flexible and the heart muscle is less strong, resulting in a smaller output and lower maximum heart rate. Systolic pressure tends to rise as a person ages. Coronary artery disease, which causes the blood vessels in the heart to receive inadequate oxygenation, can cause chest pain or heart attack. Atherosclerosis (clogging of the arteries) can also cause an increase in blood pressure.
Author Info: Deborah Eileen Parker R.N., The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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