Die systemische Hypertension bei der Katze – Diagnostik und Behandlung

Abstract

Systemic hypertension is a common medical condition in older cats, which is mostly caused by an underlying disease such as chronic kidney disease, hyperthyroidism, diabetes mellitus (predominantly diastolic hypertension) or hyperaldosteronism. Target organ damage can occur if the blood pressure is elevated. Affected organs are the eye, kidney, brain and heart. If the blood pressure exceeds 180/120 mmHg there is a high risk for the development of target organ damage. Whenever a disease with a high prevalence of hypertension is diagnosed or target organ damage is suspected, measurement of blood pressure should be performed. Indirect techniques to measure blood pressure are the Doppler sonography and the high definition oscillometry (HDO). A reliable assessment of the blood pressure can be achieved if a standardized protocol is followed. Especially the problem of ,,white coat hypertension" should be eliminated. If hypertension is diagnosed, further decisions will be made based on the severity of the hypertension and possible target organ damage. If the latter is present, medical therapy should be immediately started. If target organ damage is absent, blood pressure measurement is at first repeated to verify hypertension. The first choice medical agent is independent of the causative disease amlodipin. The treatment goal is to permanently lower the blood pressure to < 160/100 mmHg. With this approach the development of progression of target organ damage can be prevented. In most cases of affected cats, systemic hypertension and the causative disease have to be treated and monitored lifelong.