Chronic blood pressure control

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating amathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, "pressure natriuresis." Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.

Original languageEnglish (US)
Pages (from-to)2481-2494
Number of pages14
JournalComprehensive Physiology
Volume2
Issue number4
DOIs
StatePublished - Dec 1 2012

Fingerprint

Blood Pressure
Sodium
Kidney
Natriuresis
Pressure
Vascular Capacitance
Homeostasis
Body Fluids
Vascular Resistance
Arterial Pressure
Maintenance

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

Cite this

Chronic blood pressure control. / Brands, Michael W.

In: Comprehensive Physiology, Vol. 2, No. 4, 01.12.2012, p. 2481-2494.

Research output: Contribution to journalArticle

Brands, Michael W. / Chronic blood pressure control. In: Comprehensive Physiology. 2012 ; Vol. 2, No. 4. pp. 2481-2494.
@article{c84f0ee2ef3d40e98afcac1b57b8f1b2,
title = "Chronic blood pressure control",
abstract = "Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating amathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, {"}pressure natriuresis.{"} Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.",
author = "Brands, {Michael W}",
year = "2012",
month = "12",
day = "1",
doi = "10.1002/cphy.c100056",
language = "English (US)",
volume = "2",
pages = "2481--2494",
journal = "Comprehensive Physiology",
issn = "2040-4603",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Chronic blood pressure control

AU - Brands, Michael W

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating amathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, "pressure natriuresis." Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.

AB - Chronic blood pressure is maintained within very narrow limits around an average value. However, the multitude of physiologic processes that participate in blood pressure control present a bewildering array of possibilities to explain how such tight control of arterial pressure is achieved. Guyton and Coleman and colleagues addressed this challenge by creating amathematical model that integrated the short- and long-term control systems for overall regulation of the circulation. The hub is the renal-body fluid feedback control system, which links cardiac function and vascular resistance and capacitance with fluid volume homeostasis as the foundation for chronic blood pressure control. The cornerstone of that system is renal sodium excretory capability, which is defined by the direct effect of blood pressure on urinary sodium excretion, that is, "pressure natriuresis." Steady-state blood pressure is the pressure at which pressure natriuresis balances sodium intake over time; therefore, renal sodium excretory capability is the set point for chronic blood pressure. However, this often is misinterpreted as dismissing, or minimizing, the importance of nonrenal mechanisms in chronic blood pressure control. This article explains the renal basis for the blood pressure set point by focusing on the absolute dependence of our survival on the maintenance of sodium balance. Two principal threats to sodium balance are discussed: (1) a change in sodium intake or renal excretory capability and (2) a change in blood pressure. In both instances, circulatory homeostasis is maintained because the sodium balance blood pressure set point is reached.

UR - http://www.scopus.com/inward/record.url?scp=84878963692&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878963692&partnerID=8YFLogxK

U2 - 10.1002/cphy.c100056

DO - 10.1002/cphy.c100056

M3 - Article

C2 - 23720255

AN - SCOPUS:84878963692

VL - 2

SP - 2481

EP - 2494

JO - Comprehensive Physiology

JF - Comprehensive Physiology

SN - 2040-4603

IS - 4

ER -