Cardiovascular - Systemic Hypertension Flashcards
What is systemic hypertension
pathologic elevation in systemic blood pressure, usually secondary to another condition
Basic pathophysiology of systemic hypertension
arterial/arteriolar walls are diseased, vessel lumen is narrowed
reduced blood flow to tissues (ischemia) and/or hemorrhage due to vessel/capillary fragility
4 organs prone to damage? (aka target organ damage)
renal, ophthalmic, neurologic, cardiovascular
T/F: all animals with systemic hypertension show severe clinical signs
false, some are asymptomatic (which is important because it can be overlooked)
Potential clinical findings of renal damage caused by systemic hypertension
isosthenuria, azotemia, proteinuria, structural abnormalities (atrophy)
Effects of systemic hypertension on kidneys
glomerular and/or tubulointerstitial ischemia, necrosis, atrophy
Most common cause of hypertension
renal disease
Which is FALSE regarding renal damage and hypertension?
A) renal disease is the most common cause of hypertension
B) treatment of hypertension with amlodipine reduces proteinuria
C) increased proteinuria increases likelihood of survival
D) azotemia can be seen in hypertensive animals
C- decreased proteinuria increases likelihood of survival
Which of the following is FALSE regarding ophthalmic damage caused by hypertension? A) occurs in a majority of cats and dogs B) vision loss may occur C) retinal detachment is possible D) none of the above
D - none of the above are false, all are possible
clinical signs of ophthalmic damage due to hypertension
vision loss
retinal hemorrhage/edema
retinal detachment
intraocular hemorrhage (hyphema)
Potential neuro signs caused by hypertension
seizure, vestibular signs, disorientation, mentation or behaviour change
You are looking at a thoracic radiograph. There is heart enlargement at 12 o clock (think to DI)! This means there is a dilated aorta. What is a strong possibility of cause?
hypertension
T/F: myocardial diastolic dysfunction w or w/o hypertrophy can be seen in hypertensive dogs
true
Conditions that cause systemic hypertension in DOGS
renal disease, hyperadrenocorticism, DM, obesity, hyperaldosteronism, pheochromocytoma, hypothyroidism, hypertensive medication
Conditions that cause systemic hypertension in CATS
renal disease, hyperthyroidism, DM, obesity, hyperaldosteronism, pheochromocytoma
A cat comes into your clinic for a PE. It is a busy day in the clinic and there are a lot of people and animals making a lot of noise. You take a BP reading and it shows that the cat is hypertensive. Are you concerned about the results?
Yes, this could be stress induced hypertension. Rule out by changing room and personnel, find less stressful environment, ensure good technique, or try another day
A small cuff size gives a falsely ___ pressure while a large cuff size gives a falsely ___ pressure.
high, low
Key to diagnosing hypertension
look for an underlying cause (TOD)
Treatment of hypertension
reduce current TOD and reduce risk for future TOD
ACE inhibitors - indirect vasodilator, first choice in dogs (don’t use in dehydrated and hypovolemic patients)
Drug of choice to treat canine systemic hypertension
Ace inhibitors
Drug of choice to treat feline systemic hypertension
Amlodipine
Where should you measure BP
artery at the level of the heart
MoA of amlodipine
inhibits calcium influx across vascular smooth muscle cells
MoA of ace inhibitors
indirect vasodilators, blocks formation of angiotensin II (arterioconstrictor, stimulates aldosterone)
