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Vascular Resistance

Dr. Sumaiya Khan
Vascular resistance is the resistance offered by the blood vessels to the flow of blood. This story provides information about the different types of this resistance, factors influencing it, and how to calculate it.
Vascular resistance is defined as the resistance offered by the vessels to the flow of blood, which must be overcome by the blood so as to ensure sound functioning of the circulatory system. Any kind of circulatory system problems and diseases often lead to a change in this resistance.
There are two main types of this resistance: systemic or total peripheral and pulmonary. It is regulated by a number of factors, like platelet-derived substances including serotonin, endothelium-derived relaxing factor, and adenosine, to name a few.
One more type is coronary vascular resistance, which is a complex type as it depends on various factors, including metabolic, neurologic, and endothelial factors.

Factors Influencing Vascular Resistance

  • The type of vascular arrangement, ie. the exact arrangement pattern of the body's vasculature
  • The type of blood present, that is, the viscosity and thickness of blood. Also, whether the blood flow is laminar or turbulent in nature as vascular resistance and blood flow are directly related.
  • The size of the individual vessel, including its length and diameter
  • Other forces acting on the blood vessel (gravity, etc.)
  • Presence of any vascular diseases which causes blood circulation problems like atherosclerosis, peripheral vascular disease, etc. 
Certain diseases lead to vasoconstriction, i.e. constriction of the blood vessels, which increases the vascular resistance while some diseases lead to vasodilation, i.e. dilation of blood vessels, which decreases the vascular resistance.

Systemic Vascular Resistance (SVR)

Systemic or total peripheral resistance is defined as the resistance offered to the blood flow by all the systemic vasculature with the exception of the pulmonary vasculature. Peripheral resistance increases in cases of increased secretion of epinephrine and norepinephrine as these cause vasoconstriction.
This is an important concept that is often studied and used in physiology, to find out the exact cause and other factors affecting the heart and leading to heart diseases. The systemic resistance is calculated in 'dyne.sec.cm-5'. The normal SVR ranges between 900-1200 dyne.sec.cm-5
To calculate the SVR, the formula used is:
  • SVR = 80 x (MAP - MVP) / CO
where,
MAP - Mean arterial pressure, that is, the normal adult blood pressure in the arterioles of an individual
MVP - Mean venous pressure, that is, the average blood pressure in the veins in an individual
CO - Cardiac output, that is, the volume of blood pumped by a ventricle in a minute

Pulmonary Vascular Resistance (PVR)

Pulmonary resistance is defined as the resistance offered by the vasculature of the lungs. Normally, it is much lower than SVR, the normal PVR being only around 155-255 dyne.sec.cm-5. However, this PVR level is slightly the cause of its own undoing in the end as the factors that govern PVR are slightly different from those that govern SVR.
On most occasions, heart circulatory problems directly affect the PVR. For example, with any changed communication between left and right sides of the heart, blood will get diverted to the areas of low resistance from areas of high resistance, which causes an increase in the pulmonary blood flow.
This causes an increase in the PVR, thus, causing damage to the pulmonary vasculature, which may even become irreversible. To calculate the PVR, the following formula is used:
  • PVR = 80 x (MPAP - PCWP) / CO
where,
MPAP - Mean pulmonary arterial pressure, that is, the pressure in the pulmonary arterioles which can be measured with the help of an echocardiography
PCWP - Pulmonary capillary wedge pressure, which is the pressure measured in a pulmonary artery distal to an occlusion of that artery, is measured by a pulmonary artery catheter
CO - Cardiac output
Vascular resistance is an important concept that forms the basis of study and diagnosis of various cardiovascular diseases. Although this concept may seem a bit complicated initially, with time and practice, it will become easy to apply and use these formulas to measure this resistance.
Disclaimer: This Story is for informative purposes only, and should not be used as a replacement for expert medical advice.