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Systolic Blood Pressure

Blood pressure is the pressure exerted by blood on the walls of blood vessels. There are not the same pressure conditions in all areas of the circulatory system. The venous part of the circulatory system (blood flowing towards the heart) is considered a low-pressure area, while the arterial part (blood being pumped into the body) is the high-pressure area. For most medical cases, arterial pressure is significant. In cardiology, for example, central venous pressure also plays a role (the pressure in the centrally located veins just before the heart in the superior or inferior vena cava).

The Systole

In a conventional, routine blood pressure measurement, both are always measured - both the systolic and the diastolic blood pressure. The systolic (the first value in the pair of numbers) is the value that provides information about the ejection performance (stroke volume) of the heart. The second value - the diastole - occurs during the filling phase of the heart and allows conclusions about the elasticity of the large vessels. The pressure values are given in mmHg. The normal value for systole is up to 129 mmHg.

Illustration Systole and Diastole (Blood Pressure)

Physiology

The ejection performance of the heart builds up the systolic arterial pressure. This represents the pressure in the left ventricle at the moment of maximum heart muscle contraction. This pressure stretches the large vessels and, when they return to their normal expansion, transfers part of the pressure to the efferent (outgoing) vessels. This is referred to as the windkessel function or buffering function, as the elastic reaction of the large vessels absorbs blood pressure "peaks" that could otherwise reach harmful levels in the periphery. The level of systolic pressure essentially depends on three factors: heart rate, stroke volume (the product of the two results in cardiac output or cardiac minute volume), and peripheral resistance. During physical exertion, heart rate increases, and thus cardiac output also rises. The heart pumps faster to provide the body with more oxygen-rich blood. At the same time, the vessels (arterioles and precapillaries) dilate, thereby reducing peripheral resistance. However, if there are atherosclerotic changes in the vascular system, especially in the periphery, there is a restriction of the elasticity of the vessels. This restriction means that in situations of exertion, there is not sufficient dilation of the peripheral blood vessels. As a result of the high peripheral resistance, an excessively high systolic pressure occurs.

The systolic blood pressure does not remain constant in defined areas during the day. Depending on physical exertion and psychological situation, it rises and falls. Peaks of exertion occur during stress and intense physical activity. At rest and during the night, it drops to its physiological minimum. Only a high systolic resting value is considered pathological (disease-related) and requires treatment.

Sources:

By Sabine Croci. This article is medically reviewed. Last updated (12/2023).
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