Chapter 63 Systemic arterial hypertension

Question 1

Hypertension in dogs and cats are most often primary or secondary to other disease process?

Answer 1

80% of the time it is secondary

Question 2

What is end-organ or target organ damage?

Answer 2

Injury to an organ due to systemic hypertension

Question 3

What target organ is usually damaged from hypertension?

Answer 3

• Brain
• Eyes
• Kidneys
• Heart

Question 4

Which are the most common causes of systemic hypertension in cats and dogs?

Answer 4

• Acute and chronic renal failure
• DM
• HT4
• Cushings
• (hyperaldosteronism)
• (pheochromocytoma)
• (hypothyroidism)
• (polycythemia)

Question 5

What clinical sign can be seen in a patient due to the hypertension?

Answer 5

• Altered mentation
• Ataxia
• Seizure
• Nystagmus
• Acute onset or progressive blindness
• Dyspnea due to cariogenic pulmonary edema (concentric hypertrophy of L ventricle, increased diastolic filling pressure, L CHF)
• Epistaxis

Question 6

At what systolic blood pressure is initiation of treatment indicated

Answer 6

SAP <160mmHg

Question 7

What is a hypertensive emergency?

Answer 7

Acute or rapid target organ damage from hypertension

Question 8

What is a hypertensive urgency?

Answer 8

Hypertension (>180mmHg) but not accompanied by target organ damage

Question 9

What are the guidelines for reduction of blood pressure in patients with a hypertensive emergency?

Answer 9

Reduce BP by 25% within the first 1 hrs. Reduce causiously to 160mmHg within the next 2-6 hrs. Aim for normotension (<150mmHg) within 24-48hrs.

Question 10

What drugs can be used to treat a hypertensive emergency?

Answer 10

• Fenoldopam
• Hydralazine
• Nitroprusside
• Labetolol
• Phentolamine

Question 11

When to initiate treatment in hypertensive patient that is not a hypertensive emergency?

Answer 11

• Initiate treatment if BP >160mmHg
• Goal is to reduce blood pressure back to normal within several weeks.
• Start antihypertensive medication as well as treat the underlying disease.

Question 12

When is recheck recommended for all patients started on antihypertensive medications?

Answer 12

1 week.

Question 13

Is ocular disease secondary to hypertension is reversible or not?

Answer 13

It can be partially or completely reversible. But it can take weeks. And in some cases improvement is not seen at all.