Systemic hypertension in the cat aetiology and pathogenesis

摘要

A better understanding of the pathogenesis of hypertension in cats may lead to more specific diagnostic and therapeutic interventions and the prevention of target organ damage. The ACVIM consensus guidelines have been widely adopted and classify systemic hypertension according to the relative risk of developing target organ damage. Systemic hypertension is a common problem in geriatric cats and is often secondary to other diseases, mainly impaired renal function. Systemic hypertension is less prevalent in hyperthyroid cats as it has been in previous years. However, approximately 20% of cats treated for hyperthyroidism may subsequently develop hypertension but not all will have an associated azotaemia. The role of idiopathic hypertension (where no causative disease can be identified) remains controversial in cats. If hypertension is not recognised and treated, target organ damage can result. Target organ damage is mainly diagnosed in the eyes as it causes sudden-onset blindness, for example, due to hyphaema or retinal detachment. The primary aim in the treatment of systemic hypertension is the prevention of target organ damage that does not only occur in the eye, but also manifests itself in the kidneys, cardiovascular and central nervous systems. Recent studies have also begun to explore the relationship that systemic hypertension may have with proteinuria and the progression of chronic kidney disease in feline patients.