Role of RAAS

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BLOOD PRESSURE REGULATION

AND
ROLE OF RAAS

BIOPREXUM TRAINING
First day : 08.00 09.00
What Is Blood Pressure?

Blood pressure is the force on the


walls of the arteries as the blood
circulates around the body.
Blood pressure: normal values

SBP < 120 mmHg


DBP < 80 mmHg

JNC VII
Blood Pressure (BP)

BP = CO x PR

Cardiac Output Peripheral


resistance
CO = HR x SV
1. REGULATION OF BLOOD PRESSURE
Blood pressure regulation

Immediate Delayed
regulation
regulation

NERVOUS REGULATION HUMORAL REGULATION

Sympathetic System Hormones


Parasympathetic System
Blood pressure regulation :
NERVOUS

Blood pressure control by the baroreceptors


heart, carotid arteries and aorta

Communication of the information to the SNC

Nervous counter-regulation
Blood pressure regulation :
NERVOUS

BP BP
The baroreceptors
located in the carotid
sinuses detect changes
in BP.
Nervous
Nervous regulation
regulation
Sympathetic
Sympathetic parasympathetic
parasympathetic
stimulation
stimulation stimulation
stimulation

BP BP
Blood pressure regulation :
NERVOUS
Adrenaline Acetylcholine
Parasympat
Organ Sympathetic Effects hetic Effects
receptors receptors
Heart 1 cholinergic
HR HR
SV SV
excitability excitability
conductIbility conductibility

Vesel 1 >> 2 vasoconstriction no no


Kidney 1 Renin no no

Lungs bronchodilation cholinergic Broncho


constriction
Blood pressure regulation :
HUMORAL
BP BP
Angiotensin II Humoral
Aldosterone Bradykinin
Adrenaline
regulation
ADH (Antidiuretic
hormone)

BP BP
Blood pressure regulation :
HUMORAL

BP origin

Angiotensin II Plasma (& tissue)


Aldosterone Adrenal cortex
Adrenaline Adrenal medulla
ADH Posterior pituitary

BP
Blood pressure regulation :
HUMORAL

origin BP

Plasma & tissue Bradykinin

BP
Blood pressure regulation :
HUMORAL

BP Bradykinin

BP = HR x SV x PR

Angiotensin II Aldosterone Adrenaline ADH

BP
2. THE RENIN ANGIOTENSIN SYSTEM /
KALLICREIN KININ SYSTEM
Juxtaglomerular apparatus

Juxtaglomerular cells
of afferent arteriole

Macula densa cells


of distal tubule
Renin secretion
BP
blood volume
vasodilatation
Na+ / K+
sympathetic stimulation

renin
renin
The Renin Angiostensine Aldosterone
System RAAS/RAS

Plasma renin angiotensin aldosterone system


(RAAS)

Tissue renin angiotensin system


(RAS)
Plasma renin angiotensin aldosterone
system (RAAS)
BP Renin
Angiotensinogen Angiotensin I ACE
AT1
Angiotensin II
Adrenal
AT1 Cortex
S
Adrenal Sympathetic
M
C
medulla Stimulation Aldosterone

VC Adrenaline Na+ /H2O


reabsorption

HR, CO BV,SV
CO
BP
Tissue renin angiotensin
system (RAS)
Angiotensin I

Locally produced by several


ACE
organs: brain, myocardium,
kidney, lungs, arteries...
Angiotensin II
Angiotensin I is locally
transformed to Angiotensin II

Contributes to:
- vasoconstriction
- tissue growth
Angiotensin II

Angiotensin II

AT1 AT2
VC VD
Aldosterone Antithrombotic
Sympathetic stimulation Anti growth
Growth factors Apoptosis
oxidative stress
adhesion factors
PAI-1
inflammatory factors
THE KALLICREIN - KININ
SYSTEM
The kallicrein-kinin system

BP
KININOGEN
+ Kallikrein

Bradykinin
ACE + B2 Receptor

Inactivated Endothelial cell


Vascular
smooth
muscle
cell

NO, EDHF, PGI2

Vasodilation
BP Growth inhibition
Bradykinin

Bradykinin

B1 B2
VD
NO vasodilation
growth inhibition
inh of platelet activation
EDHF
PGI2
t PA
IN SUMMARY

Angiotensinogen Kininogen

Renin Kallikrein

Angiotensin Bradykinin
I
+ ACE +

Inactivated
Angiotensin
II
BP BP
tissue growth tissue growth
RAAS: a question of balance

Angiotensine II Bradykinin
Vasoconstriction Vasodilation
Adhesion of monocyte cells Antiadhesion of monocytes cells
Endothelium permeability Restore endothelium
continuity
Inflammation
Antiinflammation
SMC growth,proliferation
SMC antigrowth, antiproliferation,
and migration
antimigration
Lipid accumulation
Reduce lipid accumulation
Thrombogenesis,
Fibrinolysis
Platelet adhesion
Antiplatelet adhesion

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