REGULATION OF

CIRCULATORY SYSTEM
Department of Physiology Faculty of Medicine
Hasanuddin University
Makassar
2002

INTRODUCTION
In

humans, several circulation regulatory

mechanisms have evolved
Circulatory adjustments are affected by
altering cardiac output, changing the
diameter of resistance vessels or blood
volume
The regulatory mechanisms synergize each
other and adjust vascular responses
throughout the body
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REGULATORY MECHANISM
OF CIRCULATORY SYSTEM
Local

regulatory mechanisms

Systemic

regulation by hormones

Systemic

regulation by nervous system

Long

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term regulation by kidneys

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Local Regulatory Mechanisms

Based

on the capacity of tissues to regulate

their own blood flow (autoregulation)
Most vascular beds have an intrinsic capacity
to compensate for moderate changes in
perfusion pressure
Autoregulation consist of two mechanism:
Myogenic regulation
Metabolic regulation
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Local Regulatory Mechanisms

The

smooth muscle of the walls of the

arterioles, contracts in response to increase in
transmural pressure and relaxes in response
to a decrease in transmural pressure
Increase in longitudinal pressure induced
vasodilatation caused by the endotheliumderived relaxing factors (EDRF) such as NO
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Excitation-contraction Coupling in Vascular Smooth Muscle

Ca2+

Sarcolemma

Pl-C

PiP2

IP3 + DG

Ca2+
Sarcoplasmic
reticulum
Ca2+

Ca2+
Ca2+ + Calmodulin
Contraction

ATP
Ca2+ pump

Flow-induced Vasodilatation in Isolated Arteriole

Arteriolar diameter

1.0
0.9
0.8
0.7
0.6
0.5
0

20
40
60
80
Pressure gradient (cm H2O)

Local Regulatory Mechanisms

Endothelial

cells produce endothelium-derived

contracting factor (EDCF) and endotheliumderived relaxing factor (EDRF)
EDCF include endothelins (ET), thromboxane
A2, Angiotensin II
EDRF include

nitrit oxide (NO), prostacyclin

Adenosine, ANP, and histamine produce
relaxation independent of the endothelium
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Local Regulatory Mechanisms

According

to metabolic mechanism, blood

flow is governed by metabolic activity of the
tissue
Any intervention that results in an O2 supply
that is inadequate for requirements gives rise
to the formation of vasodilator metabolites
CO2, lactate, H+, adenosine, histamin have
been proposed as a vasodilator metabolites
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Hormonal Regulation
Vasodilator hormones:

bradykinin
vasoactive intestinal peptide (VIP)
atrial natriuretic peptide (ANP)
adrenomedullin (AM)

Vasoconstrictor hormones:

epinephrine and norepinephrine

vasopressin
angiotensin II
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Regulation by Nervous System

Autonomic

Nervous System
Sympathetic nerve
Parasympathetic nerve
Central Nervous System (Vasomotor
area)
Baroreceptors and Neural Reflexes
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Regulation by Nervous System

Sympathetic Nerve
All blood vessels except capillaries and venule
receive motor nerve fibers from sympathetic
nerve
The fibers to resistance vessels regulate tissue
blood flow and arterial pressure
The fibers to capacitance vessels regulate the
volume of blood stored in the veins
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Factors affecting the diameter of the arterioles

Constriction

Dilatation

Local factors
- Autoregulation
- Decreased local temperature

Endothelial products
- ET-1
- Thromboxan A

Circulatingh hormones
- Epinephrine (except in skeletal
muscle and liver)
- Angiotensin II, vasopressin

Neural factors
- Sympathetic and vasomotor
center activity

-CO2, decreased O2
-K+, lactate, adenosine
- local temperature, local pH
- NO
- Bradykinin
- Prostacyclin
- Epinephrine in skeletal
muscle and liver
- Histamine, ANP, VIP

- Sympathetic and vasomotor

center activity, cholinergic discharge

Regulation by Nervous System

Vasomotor Control
Consist

of groups of neurons in the medulla

oblongata that mediate sympathetic discharge to
blood vessels and heart
Afferent fibers to the vasomotor area not only from
blood vessels but also from other parts of the
nervous system and lungs
Variations in blood pressure is adjusted by
feedback control of vasomotor area, vessels
diameter and baroreceptors
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Factors affecting the activity of the vasomotor area

Direct stimulation
CO2
Hypoxia

Excitatory inputs
From cortex via hypothalamus
From pain pathways and muscle
From carotid and aortic chemoreceptors

Inhibitory inputs
From cortex via hypothalamus
From lungs
From carotid, aortic,and cardiopulmonary baroreceptors

Feedback control of blood pressure

Baroreceptors

Blood pressure

Vasomotor area
Heart rate
Stroke volume

Vessel diameter

Regulation by Nervous System

Neural reflexes, Baroreceptors and Chemoreceptors
Somatosympathetic reflex caused by pain
Baroreceptors
Dilatation of arterioles and veins
Slowing heart rate and decreased heart contractions
Chemoreceptors

Hypoxia and hypercapnia both stimulate vasomotor

area
The direct effect of hypoxia and hypercapnia to blood
vessels is vasodilatation
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Long term Regulation by Kidneys

Two

determinants of the long-term regulation of

arterial blood pressure:
Renal output of salt and water
Renin-angiotensin system

Salt

increases the extracellular fluid volume by:

increased osmolality of the body fluids

increased antidiuretic hormone secretion

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Intake NaCl
Tekanan darah
Volume CES
Stres/Trauma

Angiotensinogen
Renin
Angiotensin I

Makula Densa, Baroreseptor, Susunan Saraf Simpatis

ACE
Angiotensin II

Sel Juxtaglomerular

Adrenal
Aldosteron

Reabsorbsi
Na

Ginjal
Vasokonstriksi

Aliran darah
Reabsorbsi
Na

P. Darah

Jantung

Otak

Faktor
Pertumbuhan

Vasokonstriksi

Tahanan
Perifer

Kontraksi ADH
Simpatis

Proliferasi
otot polos

SUMMARY OF THE INTEGRATED

REGULATION OF BLOOD PRESSURE

Rapid acting blood pressure control (within seconds or

minute): 1) baroreceptor feedback mechanism, 2)
vasomotor mechanism and 3) chemoreceptor mechanism

Intermediate

time period (within 30 min to several

hours): 1) renin-angiotensin system, 2) stress-relaxation
mechanism and 3) shift of fluid through the capillary
walls in and out of the circulation
Long-term mechanism (days to years): 1) renal-blood
volume pressure control and 2) renin-angiotensin system

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