DIAGNOSIS OF SYSTEMIC ARTERIAL HYPERTENSION (SAH) IN CATS

Abstract

Systemic Arterial Hypertension (SAH) is a clinical condition of increasing relevance in feline medicine, being highly prevalent in older cats and frequently associated with comorbidities such as Chronic Kidney Disease (CKD). Persistent elevation of Systolic Blood Pressure (SBP) carries a risk of severe damage to target organs, such as the eyes, central nervous system, kidneys, and heart. Diagnosis is challenged by situational hypertension, the "white coat effect," which can mask the patient's true condition, requiring repeated measurements and investigation of target organ lesions for confirmation. This study, a narrative literature review conducted in the PubMed database, aimed to synthesize and analyze the most recent evidence on the diagnosis of SAH in felines. The results indicate that the diagnosis is established by measuring SBP, adopting a threshold of 160 mmHg on at least two distinct occasions, preferably using the flow Doppler technique. For diagnostic accuracy, multiple consecutive measurements are recommended, discarding the first reading, in addition to minimizing environmental stress. The etiology of systemic hypertension is predominantly secondary, with chronic kidney disease (CKD) identified as the most common underlying cause (affecting up to 83% of hypertensive cats). Systemic repercussions of hypertension include cardiovascular changes, such as left ventricular hypertrophy and myocardial fibrosis, and severe ocular lesions, such as hypertensive retinopathy. Therefore, successful diagnosis must be comprehensive, encompassing the analysis of target organ damage to determine disease severity and ensure detailed and effective clinical management.