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The reduction in the rate of systolic ejection following elevation of aortic pressure leads to changes in cardiac output opposite to alteration in peripheral resistance, thus tending to maintain a relatively constant arterial pressure.
The factors that primarily determine the work of the heart include systolic blood pressure (BP), blood viscosity, and the volume of blood the myocardium has to pump. The relationship between BP and viscosity is such that, given a constant systolic BP, if blood viscosity increases, then the total peripheral resistance (TPR) will necessarily increase, thereby reducing blood flow. Conversely, when viscosity decreases, blood flow and perfusion will increase. Because of the dependence of systemic arterial BP on cardiac output and TPR, if blood viscosity and TPR rise, systolic BP must then increase for cardiac output to be maintained.