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, 14:38, 1 July 2010
'''Description:'''
*Hypertension is defined as the pathological elevation of arterial blood pressure.
*There are two main types of hypertension, systemic hypertension (affects the systemic circulation) and pulmonary hypertension (affects the pulmonary circulation).
*Blood pressure in veterinary patients is not measured routinely; therefore hypertension is usually only diagnosed after clinical signs become apparent.
===Systemic Hypertension===
*Primary systemic hypertension= idiopathic increase in arterial blood pressure
*Secondary systemic hypertension=increase in arterial blood pressure secondary to a pathological process
*The ocular system, cardiovascular system, and nervous system are the most vulnerable to elevated arterial blood pressures. However, some endocrine disturbances have also been found to predispose animals to hypertension.
====Signalment====
'''Dogs''': male>female; obese animals; middle to old age
'''Cats''': middle to old age
====Diagnosis====
=====History & Clinical Signs=====
*Signs are the result of ischemia, edema, and/or haemorrhage of the affected areas
=====Neurological Signs=====
-Depression
-Seizures
-Syncope
-Paresis
-Vestibular Signs
-Ataxia
=====Cardiac Signs=====
-Left Ventricular Hypertrophy
-Heart Failure
-Systolic Murmur
-Gallop rhythm
=====Ocular Signs=====
*In cats, ocular abnormalities from hypertension are usually the first thing detected.
-Blindness
=====Fundic Examination=====
-Hyphemia (Blood in the anterior chamber)
-Retinal Haemorrhage
-Retinal Detachment
-Retinal Degeneration
=====Renal Signs=====
*Renal disease can both be caused by hypertension and cause hypertension.
*Chronic renal failure is the most common cause of hypertension showing clinical signs in dogs and cats.
-Renal Disease (especially glomerular damage)
*Glomerular damage allows protein leakage, therefore animals with hypertension are more proteinuric than unaffected animals
=====Endocrine Signs=====
-Hyperthyroidism (cats)
-Hyperadrenocorticism, Diabetes Mellitus (dogs)
=====Physical Exam=====
'''Blood Pressure Measurement'''
*Systolic Pressure> 175 indicates hypertension in a relaxed dog or cat
*Diastolic Pressure> 100 indicates hypertension in a relaxed dog or cat
'''1. Direct Blood Pressure Measurement (Invasive)
'''
*Uses an indwelling arterial catheter
-Measures systolic, diastolic, and mean arterial pressures
-Used on very ill patients or those undergoing anaesthesia
'''2. Indirect Blood Pressure Measurement (Non-invasive)
'''
*Two types that measure systolic arterial pressure
-Doppler Flow Technique: good for large dogs, poor for cats
-Oscillometric Technique: good for small dogs, good for cats
=====Treatment=====
'''Cats'''
*Treat the underlying problems
*Calcium Channel Blocker (e.g. amlodipine)
*Monitor Blood Pressure
'''Dogs'''
*Treat the underlying problems
*Monitor Blood Pressure
'''Dogs with Renal Disease:'''
*ACE-inhibitor (e.g. enalopril): Given alone or in combination with some of the other treatments listed below.
*Calcium Channel Blocker (e.g. amlodipine)
*Sodium Restricted Diet
*Beta Blockers (e.g. atenolol)
*Diuretics (e.g furosemide)
*Vasodilators (e.g. enalopril)
=====Prognosis=====
-Cats with hypertension are more successfully treated than dogs.
[[Category:Arterial_Pathology]][[Category:To_Do_-_Cardiovascular]]