Canis ISSN: 2398-2942

Hypertension

Contributor(s): Serena Brownlie, Mark Rishniw, Esther Bijsmans

Introduction

  • Consistent increase in arterial blood pressure above the species normal.
  • Cause: usually secondary, eg chronic renal failure. Primary (idiopathic) cases have been reported.
  • Dogs are relatively resistant to hypertension.
  • Probably underdiagnosed in veterinary medicine.
  • Signs: PUPD, blindness, seizures, behavioral changes.
  • Diagnosis: early screening and identification important to prevent organ damage (particularly eyes, central nervous system, heart and kidney).
  • Treatment: address underlying cause.
  • Prognosis: good if hypertension controlled.
    Print off the owner factsheet on Hypertension (high blood pressure) Hypertension (high blood pressure) to give to your client.
Follow the diagnostic tree for Hypertension Hypertension.

Pathogenesis

Predisposing factors

General
  • Age.
  • Obesity Obesity.
  • High salt diet.

Specific

Pathophysiology

  • Blood pressure varies with age, breed, sex, exercise and diet.
  • Stage II hypertension:
    • Sustained high pressure regardless of other clinical findings.
    • Systolic blood pressure >180 mmHg or diastolic blood pressure > 110 mmHg.
    • Requires anti-hypertensive treatment.
  • Stage I hypertension:
    • Consistent high pressure associated with clinical abnormalities eg retinal lesions or chronic renal disease.
    • Systolic blood pressure 160-179 mmHg or diastolic blood pressure 100-109 mmHg.
    • Anti-hypertensive treatment indicated.
  • Pre-hypertensive
    • Moderately elevated pressure with no other clinical abnormalities related to systemic hypertension.
    • Systolic blood pressure 140-159 mmHg or diastolic blood pressure 90-99 mmHg.
    • Requires careful observation and bi-annual reassessment.
      Normal blood pressure is systolic pressure <140 mmHg and diastolic pressure <90 mm Hg.
  • Depends on cause.
Generally
  • Vascular wall stiffness, eg arteriosclerosis.
  • Renin-angiotensin-aldosterone system activation → altered adrenergic activity → renal vasodepressor/vasopressor substances. For example, decreased renal blood flow → renin/angiotensin release → further Na retention and vasoconstriction → increased renopressor substance production.
  • Anemia → increased cardiac output.

Timecourse

  • Usually chronic organ damage.
  • May present acutely when organ damage occurs.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Brown S et al (2007) Guidelines for the Identification, Evaluation, and Management of Systemic Hypertension in Dogs and Cats. J Vet Intern Med 21 (3), 542-558 PubMed.
  • Acierno M J & Labato M A (2005) Hypertension in renal disease: diagnosis and treatment. Clin Tech Small Anim Pract 20 (1), 23-30 PubMed.
  • Bodey A R & Rampling M W (1999) Comparison of haemorrheological parameters and blood pressure in various breeds of dog. JSAP 40 (1), 3-6 PubMed.
  • Henik R A (1997) Systemic hypertension and its management. Vet Clin North Am Small Anim Pract​ 27 (6), 1355-1372 PubMed.
  • Bodey A R, Michell A R, Bovee K C et al (1996) Comparison of direct and indirect (oscillometric)​ measurements of arterial blood pressure in conscious dogs. Res Vet Sci 61 (1), 17-21 PubMed.
  • Michell A R (1993) Hypertension in companion animals. Vet Annual 33, 11-23 VetMedResource.
  • Dukes J (1992) Hypertension - a review of the mechanisms, manifestations and management. JSAP 33 (3), 119-129 VetMedResource.

Other sources of information

  • Brown S A (2004)Canine hypertension: risk and management.Proceedings of the North American Veterinary Conference.
  • Littman M P & Drobatz K J (1995)Hypertensive and hypotensive disorders.In:Textbook of Veterinary Internal Medicine.4th edn. Eds S J Ettinger & E C Feldman. Philadelphia: W B Saunders pp 93-97.
  • Michell A R & Bodey A R (1994)Canine hypertension.Proceedings 12th American College of Veterinary Internal Medicine ConferenceACVIM, pp 502-505. (Results of a survey of blood pressure in normal dogs.)


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