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Low Blood Pressure (Hypotension)

How does the body maintain normal blood pressure?

The body has mechanisms to alter or maintain blood pressure and blood flow. There are sensors that sense blood pressure in the walls of the arteries and send signals to the heart, the arterioles, the veins, and the kidneys that cause them to make changes that lower or increase blood pressure.

There are several ways in which blood pressure can be adjusted; by adjusting the amount of blood pumped by the heart into the arteries (cardiac output), the amount of blood contained in the veins, the arteriolar resistance, and the volume of blood.

  • The heart can speed up and contract more frequently and it can eject more blood with each contraction. Both of these responses increase the flow of blood into the arteries and increase blood pressure.
  • The arterioles can expand and narrow. Expanded arterioles create less resistance to the flow of blood and decrease blood pressure, while narrowed arterioles create more resistance and raise blood pressure.

For example, low blood volume due to bleeding (such as a bleeding ulcer in the stomach or from a severe laceration from an injury) can cause low blood pressure. The body quickly responds to the low blood volume and pressure by the following adjustments which all increase blood pressure:

  • The heart rate increases and the forcefulness of the heart's contractions increase, pumping more blood through the heart.
  • Veins narrow to return more blood to the heart for pumping.
  • Blood flow to the kidneys decreases to reduce the formation of urine and thereby increases the volume of blood in the arteries and veins.
  • Arterioles narrow to increase resistance to blood flow.

These adaptive responses will keep the blood pressure in the normal range unless blood loss becomes so severe that the responses are overwhelmed.

Reviewed on 7/14/2014

