Charla realizada por Alexis Santana, cardiólogo en Albea Veterinarios. Enmarcada dentro del "I curso de especialización en cardiología de pequeños animales". Colegio Oficial de Veterinaria de Las Palmas de Gran Canaria, 17 de diciembre de 2011.

1. MEDICIÓN DE PRESIÓN ARTERIAL
Alexis J. Santana González.
cardiologia@albeaveterinarios.com
www.albeaveterinarios.com

2. MEDICIÓN DE PRESIÓN ARTERIAL
Alexis J. Santana González.
cardiologia@albeaveterinarios.com
www.albeaveterinarios.com

3. MEDICIÓN DE PRESIÓN ARTERIAL
Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
Métodos para medirla. Cómo, dónde y por quién.Valores de referencia.
Tratamiento HAS (ACVIM CONSENSUS) en referencia a un caso

4. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
Se denomina Hipertensión Arterial Sistémica HAS a la elevación crónica de la presión arterial.
HIPERTENSIÓN HIPERTENSIÓN EFECTO
IDIOPATICA SECUNDARIA BATA BLANCA
Es la causada por una Es la hipertensión causada
En humana se denomina enfermedad o condición por la propia acción de la
Esencial o primaria. (incluida la administración toma de medida de presión.
Sin causa secundaria. de fármacos) que causan Por ello se han establecido
hipertensión. uno protocolo para la toma
de medida.

5. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
Se denomina Hipertensión Arterial Sistémica HAS a la elevación crónica de la presión arterial.
HIPERTENSIÓN HIPERTENSIÓN EFECTO
IDIOPATICA SECUNDARIA BATA BLANCA
Es la causada por una Es la hipertensión causada
En humana se denomina enfermedad o condición por la propia acción de la
Esencial o primaria. (incluida la administración toma de medida de presión.
Sin causa secundaria. de fármacos) que causan Por ello se han establecido
hipertensión. uno protocolo para la toma
de medida.

6. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
Se denomina Hipertensión Arterial Sistémica HAS a la elevación crónica de la presión arterial.
HIPERTENSIÓN HIPERTENSIÓN EFECTO
IDIOPATICA SECUNDARIA BATA BLANCA
Es la causada por una Es la hipertensión causada
En humana se denomina enfermedad o condición por la propia acción de la
Esencial o primaria. (incluida la administración toma de medida de presión.
Sin causa secundaria. de fármacos) que causan Por ello se han establecido
hipertensión. uno protocolo para la toma
de medida.

7. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
Se denomina Hipertensión Arterial Sistémica HAS a la elevación crónica de la presión arterial.
HIPERTENSIÓN HIPERTENSIÓN EFECTO
IDIOPATICA SECUNDARIA BATA BLANCA
Es la causada por una Es la hipertensión causada
En humana se denomina enfermedad o condición por la propia acción de la
Esencial o primaria. (incluida la administración toma de medida de presión.
Sin causa secundaria. de fármacos) que causan Por ello se han establecido
hipertensión. uno protocolo para la toma
de medida.

8. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
EFECTO BATA BLANCA
Protocolo por años, 2, 5, 7 y 9 años...

9. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
EFECTO BATA BLANCA
Reposo en la mesa 5-10 minutos
Siempre misma persona (auxiliar?)
Apuntar extremidad
Siempre mismo manguito (40% del
diámetro)
¿Repetir varias tomas y media?
Protocolo por años, 2, 5, 7 y 9 años...

10. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
EFECTO BATA BLANCA
Reposo en la mesa 5-10 minutos
Siempre misma persona (auxiliar?)
Apuntar extremidad
Siempre mismo manguito (40% del
diámetro)
¿Repetir varias tomas y media?
Protocolo por años, 2, 5, 7 y 9 años...
3 mm/Hg por año

11. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

12. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

13. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

14. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

15. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

16. Table 4. Diseases associated with secondary hypertension g
in dogs and cats. fr
HIPERTENSIÓN Prevalence of
ce
h
SECUNDARIA Disease or Condition Hypertension (%) Reference(s) el
Dogs ti
Chronic kidney disease 93 163 th
60 164 th
Es la causada por una 80 164 o
enfermedad o condición 79
9
168
42
su
n
(incluida la administración 62 101 d
19 169
de fármacos) que causan Acute kidney disease 87 170
to
fo
hipertensión. Hyperadrenocorticism
Native 73 81,168
p
La hipertensión puede Iatrogenic 80 in
ev
persistir o incluso aumentar Diabetes mellitus 46
24
171
168 m
una vez tratada la causa Obesity small effect 33,42,72,78 d
Primary hyperaldo- rare disease 172
primaria, por lo que steronism
requiere de controles Pheochromocytoma 43%
86%
173
174
posteriores. Hypothyroidism uncommon 175 re
Cats h
Chronic kidney disease 46 69 th
65 105 to
19 176 m
Diabetes mellitus 0 55 p
no increase of BP to
Hyperthyroidism 87 65 tr
23 69 in
5 pre-treatment and 105 a
25 post-treatment 82
ev
Obesity hypertension 59
uncommon
sh
Primary hyperaldo- 50%–100% 89,177–183
steronism uncommon disease
Pheochromocytoma up to 100% unusual 184, 185
disease
o

17. Table 4. Diseases associated with secondary hypertension generally due to autonomic nervous system alterations
from the effects of excitement or anxiety on higher
in dogs and cats. Systolic blood pressure in cats
SMALL ANIMALS
centers of the central nervous system. This type of
Prevalence of
with diabetes mellitus
hypertension resolves under conditions that reduce or
Disease or Condition Hypertension (%) Reference(s) eliminate the artifact (eg, DVM; Rhonda measurement, DACVIM; Robert Prosek, DVM;
altering L. Schulman, DVM condi-
Kathleen A. Sennello,
Dogs tions to reduce the animal’s anxietyM. Siegel, DVM, PhD BP at
Arthur or measuring
Chronic kidney disease 93 163 the animal’s home). Although there is some evidence
60 164 that the presence of white-coat hypertension the duration in humans,increases. To our
similar to the in an
increasing as
prevalence
of disease
with prevalence
3
80 164 otherwise normotensive mellitusofand estab- a risk factor for prevalence of hypertension in
Objective—To determine the prevalence systemic
hypertension in cats with diabetes
person is knowledge, however, the
79 cats with diabetes mellitus has not been reported. On the
79 168 subsequent for echocardiographic variables in diabetic there is presently
lish ranges hypertensive damage, other hand, diabetes mellitus has been linked to chron-
cats.
9 42 ic pancreatitis, retinopathy, obesity, and neuropathy in
no justification for treating white-coat hypertensionhypertension is being diagnosed with
in
Design—Prospective study. cats. In addition, 4-7
62 101 dogs Animals—14 cats with diabetes mellitus and 19
or cats. Anxiety-induced increases in BP can lead older cats, in part because of
increasing frequency in
healthy control cats. increases in life span but primarily because of increased
19 169 to a Procedure—Systolic blood of systemic hypertension.33,44theUn-
false diagnosis pressure was measured recognition of condition. Common clinical signs of
Acute kidney disease 87 170 indirectly with a noninvasive Doppler technique. hypertension in cats included ocular abnormalities asso-
fortunately, and echocardiographic examinations onciated with hypertensive retinopathy and heart mur-
Ophthalmic the effects of anxiety BP are not
Hyperadrenocorticism were performed, and urine protein concentration was
Native 73 81,168
predictable, Cats some animalshave hyperten- dramatic increase left ventricular hypertrophy.
measured. as were considered to exhibit a
murs associated with
Hypertension is most commonly secondary to chronic
Iatrogenic 80 in BP whereas others pressure typically asso-
sion if they had systolic blood do not, andHg
and at least 1 other clinical abnormality
> 180 mm some animals may
renal failure and hyperthyroidism, with primary hyper-
8
Diabetes mellitus 46 171 even ciated with hypertension (eg, hypertensive retinopa- a reportedbeingof the rare. The the prevalence of sys-
exhibit a decrease in BP as
thy, left ventricular hypertrophy, or proteinuria).
result relativelydetermine purposes of the study
tension
here were to
16 temic hypertension in cats with diabetes mellitus and
24 168 measurement process. The latter had
Results—None of the diabetic or control cats effect presumably is
establish ranges for echocardiographic variables in dia-
systolic blood pressure > 180 mm Hg. One diabetic
Obesity small effect 33,42,72,78 due to had left ventricular hypertrophy, but systolic blood overactivity.
cat parasympathetic nervous system betic cats.
pressure was 174 mm Hg. None of the cats had evi-
Primary hyperaldo- rare disease 172 dence of hypertensive retinopathy or proteinuria. Materials and Methods
steronism Cats—Fourteen cats with diabetes mellitus examined at
Mean values for echocardiographic variables for the
Secondary Hypertension the University of Illinois Veterinary Teaching Hospital and 19
diabetic cats were not significantly different from pub-
Pheochromocytoma 43% 173 lished values for healthy cats. healthy control cats were included in the study. In the cats
with diabetes mellitus, the diagnosis was made on the basis
86% 174 This type of hypertension involves high BP concur-
Conclusions and Clinical Relevance—Results sug-
of appropriate clinical signs (eg, polyuria and polydipsia),
gest that hypertension does not occur or occurs in
Hypothyroidism uncommon 175 rent with clinical disease or a condition known to cause
only a small percentage of cats with diabetes melli- high serum glucose concentration (> 250 mg/dL), and detec-
tus. (J Am Vet Med Assoc 2003;223:198–201) tion of glucose in the urine with a dipstick. To rule out stress
Cats hypertension (Table 4) or hypertension associated with glycemia as the cause of the high serum glucose concentra-
tion, cats were included in the study only if serum fruc-
the administration ofintherapeutic agents that are known
Chronic kidney disease 46
65
69
105
H ypertension is common humans with diabetes mel-
to cause nephropathy, neuropathy,tocardiomyopathy, and glucocorticoids,
litus and contributes greatly
diabetic an elevation of BP, such as
the development of
tosamine concentration had been found to be high (> 285
µmol/L) during the preceding 12 months or if a 24-hour
blood glucose concentration curve demonstrated persistent
hyperglycemia. To exclude cats with confounding diseases,
retinopathy. The prevalence of hypertension in diabetic
mineralocorticoids, erythropoietin, sodium chloride, cats were included only if serum thyroxine (T4) concentra-
19 176 human patients reportedly ranges from 40 to 80%, with tion, measured within the preceding 12 months, was within
Diabetes mellitus 0 55 phenylpropanolamine, and nonsteroidal anti-inflamma-
prevalence and severity increasing as glycemic control
1
reference limits and a urinalysis performed during the same
no increase of BP torydecreases andcommon in humansincreases. In fact, hyper- despite effective
drugs. duration of disease with diabetic nephropa-
tension is so Hypertension may persist
period did not reveal protein or if results of bacterial culture
of a urine sample were negative. Cats with diabetic ketoaci-
dosis that had ketones in their urine were excluded from the
Hyperthyroidism 87 65 treatment ofoftheearly in the course of theto control of and the BP may
thy and develops so primary condition80–82
strict control blood pressure, as opposed
disease that
study, as were cats with evidence of severe concurrent dis-
23 69 83
increaseglucose concentration, results in improvement of The presence of
blood after therapy is initiated. ease. None of the diabetic or control cats were receiving any
medications known to have effects on blood pressure.
5 pre-treatment and 105 a condition anddemonstrable microalbuminuria is the
renal function
known to cause nephropathy.
In these patients,
slows progression of the
secondary hypertension, Age distribution of the control cats was similar to that of
the diabetic cats. Control cats were considered healthy on the
25 post-treatment 82 2
even ifRecent subclinical,suggests progressiveprevalence of
hallmark of
effectively possibly that the renal disease.
evidence
resolved by therapeutic intervention, basis of results of a physical examination, CBC, serum bio-
Obesity hypertension 59 chemistry panel (including measurement of serum T4 con-
uncommon
should promptdogs with diabetes mellitusevaluations.
hypertension in serial follow-up (46%) is centration), and urinalysis.
Because hypertension is more common in human
Primary hyperaldo- 50%–100% 89,177–183 From the Department of Veterinary Clinical Medicine, College of patients with poorly controlled diabetes, the degree of
Veterinary Medicine, University of Illinois, Urbana, IL 61801. Dr. glycemic control in diabetic cats was evaluated by measuring
steronism uncommon disease Idiopathic Hypertension
Sennello’s present address is the Department of Small Animal serum fructosamine concentration9 and calculating mean
Clinical Sciences, Virginia-Maryland Regional College of blood glucose (MBG) concentration during a 24-hour peri-
Pheochromocytoma up to 100% unusual 184, 185 Veterinary Medicine, Virginia-Tech and University of Maryland, od. Fructosamine concentrations < 350 µmol/L were consid-
The terms primary or essential hypertension have
Blacksburg, VA 24061-0442. ered evidence of excellent glycemic control, between 350 and
disease Address correspondence to Dr. Schulman. 450 µmol/L were considered evidence of good control,
often been used in people to describe hypertension in the

18. Table 4. Diseases associated with secondary hypertension generally due to autonomic nervous system alterations
from the effects of excitement or anxiety on higher
in dogs and cats. Systolic blood pressure in cats
SMALL ANIMALS
centers of the central nervous system. This type of
Prevalence of
with diabetes mellitus
hypertension resolves under conditions that reduce or
Disease or Condition Hypertension (%) Reference(s) eliminate the artifact (eg, DVM; Rhonda measurement, DACVIM; Robert Prosek, DVM;
altering L. Schulman, DVM condi-
Kathleen A. Sennello,
Dogs tions to reduce the animal’s anxietyM. Siegel, DVM, PhD BP at
Arthur or measuring
Chronic kidney disease 93 163 the animal’s home). Although there is some evidence
60 164 that the presence of white-coat hypertension the duration in humans,increases. To our
similar to the in an
increasing as
prevalence
of disease
with prevalence
3
80 164 otherwise normotensive mellitusofand estab- a risk factor for prevalence of hypertension in
Objective—To determine the prevalence systemic
hypertension in cats with diabetes
person is knowledge, however, the
79 cats with diabetes mellitus has not been reported. On the
79 168 subsequent for echocardiographic variables in diabetic there is presently
lish ranges hypertensive damage, other hand, diabetes mellitus has been linked to chron-
cats.
9 42 ic pancreatitis, retinopathy, obesity, and neuropathy in
no justification for treating white-coat hypertensionhypertension is being diagnosed with
in
Design—Prospective study. cats. In addition, 4-7
62 101 dogs Animals—14 cats with diabetes mellitus and 19
or cats. Anxiety-induced increases in BP can lead older cats, in part because of
increasing frequency in
healthy control cats. increases in life span but primarily because of increased
19 169 to a Procedure—Systolic blood of systemic hypertension.33,44theUn-
false diagnosis pressure was measured recognition of condition. Common clinical signs of
Acute kidney disease 87 170 indirectly with a noninvasive Doppler technique. hypertension in cats included ocular abnormalities asso-
fortunately, and echocardiographic examinations onciated with hypertensive retinopathy and heart mur-
Ophthalmic the effects of anxiety BP are not
Hyperadrenocorticism were performed, and urine protein concentration was
Native 73 81,168
predictable, Cats some animalshave hyperten- dramatic increase left ventricular hypertrophy.
measured. as were considered to exhibit a
murs associated with
Hypertension is most commonly secondary to chronic
Iatrogenic 80 in BP whereas others pressure typically asso-
sion if they had systolic blood do not, andHg
and at least 1 other clinical abnormality
> 180 mm some animals may
renal failure and hyperthyroidism, with primary hyper-
8
Diabetes mellitus 46 171 even ciated with hypertension (eg, hypertensive retinopa- a reportedbeingof the rare. The the prevalence of sys-
exhibit a decrease in BP as
thy, left ventricular hypertrophy, or proteinuria).
result relativelydetermine purposes of the study
tension
here were to
16 temic hypertension in cats with diabetes mellitus and
24 168 measurement process. The latter had
Results—None of the diabetic or control cats effect presumably is
establish ranges for echocardiographic variables in dia-
systolic blood pressure > 180 mm Hg. One diabetic
Obesity small effect 33,42,72,78 due to had left ventricular hypertrophy, but systolic blood overactivity.
cat parasympathetic nervous system betic cats.
pressure was 174 mm Hg. None of the cats had evi-
Primary hyperaldo- rare disease 172 dence of hypertensive retinopathy or proteinuria. Materials and Methods
steronism Cats—Fourteen cats with diabetes mellitus examined at
Mean values for echocardiographic variables for the
Secondary Hypertension the University of Illinois Veterinary Teaching Hospital and 19
diabetic cats were not significantly different from pub-
Pheochromocytoma 43% 173 lished values for healthy cats. healthy control cats were included in the study. In the cats
with diabetes mellitus, the diagnosis was made on the basis
86% 174 This type of hypertension involves high BP concur-
Conclusions and Clinical Relevance—Results sug-
of appropriate clinical signs (eg, polyuria and polydipsia),
gest that hypertension does not occur or occurs in
Hypothyroidism uncommon 175 rent with clinical disease or a condition known to cause
only a small percentage of cats with diabetes melli- high serum glucose concentration (> 250 mg/dL), and detec-
tus. (J Am Vet Med Assoc 2003;223:198–201) tion of glucose in the urine with a dipstick. To rule out stress
Cats hypertension (Table 4) or hypertension associated with glycemia as the cause of the high serum glucose concentra-
tion, cats were included in the study only if serum fruc-
the administration ofintherapeutic agents that are known
Chronic kidney disease 46
65
69
105
H ypertension is common humans with diabetes mel-
to cause nephropathy, neuropathy,tocardiomyopathy, and glucocorticoids,
litus and contributes greatly
diabetic an elevation of BP, such as
the development of
tosamine concentration had been found to be high (> 285
µmol/L) during the preceding 12 months or if a 24-hour
blood glucose concentration curve demonstrated persistent
hyperglycemia. To exclude cats with confounding diseases,
retinopathy. The prevalence of hypertension in diabetic
mineralocorticoids, erythropoietin, sodium chloride, cats were included only if serum thyroxine (T4) concentra-
19 176 human patients reportedly ranges from 40 to 80%, with tion, measured within the preceding 12 months, was within
Diabetes mellitus 0 55 phenylpropanolamine, and nonsteroidal anti-inflamma-
prevalence and severity increasing as glycemic control
1
reference limits and a urinalysis performed during the same
no increase of BP torydecreases andcommon in humansincreases. In fact, hyper- despite effective
drugs. duration of disease with diabetic nephropa-
tension is so Hypertension may persist
period did not reveal protein or if results of bacterial culture
of a urine sample were negative. Cats with diabetic ketoaci-
dosis that had ketones in their urine were excluded from the
Hyperthyroidism 87 65 treatment ofoftheearly in the course of theto control of and the BP may
thy and develops so primary condition80–82
strict control blood pressure, as opposed
disease that
study, as were cats with evidence of severe concurrent dis-
23 69 83
increaseglucose concentration, results in improvement of The presence of
blood after therapy is initiated. ease. None of the diabetic or control cats were receiving any
medications known to have effects on blood pressure.
5 pre-treatment and 105 a condition anddemonstrable microalbuminuria is the
renal function
known to cause nephropathy.
In these patients,
slows progression of the
secondary hypertension, Age distribution of the control cats was similar to that of
the diabetic cats. Control cats were considered healthy on the
25 post-treatment 82 2
even ifRecent subclinical,suggests progressiveprevalence of
hallmark of
effectively possibly that the renal disease.
evidence
resolved by therapeutic intervention, basis of results of a physical examination, CBC, serum bio-
Obesity hypertension 59 chemistry panel (including measurement of serum T4 con-
uncommon
should promptdogs with diabetes mellitusevaluations.
hypertension in serial follow-up (46%) is centration), and urinalysis.
Because hypertension is more common in human
Primary hyperaldo- 50%–100% 89,177–183 From the Department of Veterinary Clinical Medicine, College of patients with poorly controlled diabetes, the degree of
Veterinary Medicine, University of Illinois, Urbana, IL 61801. Dr. glycemic control in diabetic cats was evaluated by measuring
steronism uncommon disease Idiopathic Hypertension
Sennello’s present address is the Department of Small Animal serum fructosamine concentration9 and calculating mean
Clinical Sciences, Virginia-Maryland Regional College of blood glucose (MBG) concentration during a 24-hour peri-
Pheochromocytoma up to 100% unusual 184, 185 Veterinary Medicine, Virginia-Tech and University of Maryland, od. Fructosamine concentrations < 350 µmol/L were consid-
The terms primary or essential hypertension have
Blacksburg, VA 24061-0442. ered evidence of excellent glycemic control, between 350 and
disease Address correspondence to Dr. Schulman. 450 µmol/L were considered evidence of good control,
often been used in people to describe hypertension in the

19. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

20. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

21. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

22. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

23. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

24. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Corazón No sólo es interesante para el control de otras patologías
cardiacas que cursan con hipertensión.
La hipertensión produce en el sistema vascular y cardiaco:
Alteración en la íntima de la vasculatura arterial
Activación del sistema RAA
Aumenta la postcarga cardiaca
Fibrosis e hipertrofia cardiaca

25. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
El cerebro trabaja a 60 - 150 mm/Hg.
Cerebro El exceso de tensión puede producir filtración desde los vasos
sanguíneos con el consecuente edema.
Lo signos que podemos observar son:
Alteraciones en los pares craneales
Convulsiones
Somnolencia
Trastornos del comportamiento

26. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
El cerebro trabaja a 60 - 150 mm/Hg.
Cerebro El exceso de tensión puede producir filtración desde los vasos
sanguíneos con el consecuente edema.
Lo signos que podemos observar son:
Alteraciones en los pares craneales
Convulsiones
Somnolencia
Trastornos del comportamiento

27. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
El cerebro trabaja a 60 - 150 mm/Hg.
Cerebro El exceso de tensión puede producir filtración desde los vasos
sanguíneos con el consecuente edema.
Lo signos que podemos observar son:
Alteraciones en los pares craneales
Convulsiones
Somnolencia
Trastornos del comportamiento

28. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
El cerebro trabaja a 60 - 150 mm/Hg.
Cerebro El exceso de tensión puede producir filtración desde los vasos
sanguíneos con el consecuente edema.
Lo signos que podemos observar son:
Alteraciones en los pares craneales
Convulsiones
Somnolencia
Trastornos del comportamiento

29. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
El cerebro trabaja a 60 - 150 mm/Hg.
Cerebro El exceso de tensión puede producir filtración desde los vasos
sanguíneos con el consecuente edema.
Lo signos que podemos observar son:
Alteraciones en los pares craneales
Convulsiones
Somnolencia
Trastornos del comportamiento

30. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Ojos El ojo es el órgano diana de mayor riesgo, no tanto por la
frecuencia con la que se afecta, sino por la vulnerabilidad de éste
al afectarse.
- Edemas de retina
- Tortuosidad de los vasos de la retina
- Hemorragias retinales
- Desprendimientos de retina (completos o
parciales)
- Secundariamente pueden aparecer
degeneraciones de retina (en casos más avanzados)
- Glaucoma en algunos casos (más frecuente en
gatos)
Gracias a Raquel Udiz y
Visión Veterinaria por las
imágenes

31. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Ojos El ojo es el órgano diana de mayor riesgo, no tanto por la
frecuencia con la que se afecta, sino por la vulnerabilidad de éste
al afectarse.
- Edemas de retina
- Tortuosidad de los vasos de la retina
- Hemorragias retinales
- Desprendimientos de retina (completos o
parciales)
- Secundariamente pueden aparecer
degeneraciones de retina (en casos más avanzados)
- Glaucoma en algunos casos (más frecuente en
gatos)
Gracias a Raquel Udiz y
Visión Veterinaria por las
imágenes

32. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Ojos El ojo es el órgano diana de mayor riesgo, no tanto por la
frecuencia con la que se afecta, sino por la vulnerabilidad de éste
al afectarse.
- Edemas de retina
- Tortuosidad de los vasos de la retina
- Hemorragias retinales
- Desprendimientos de retina (completos o
parciales)
- Secundariamente pueden aparecer
degeneraciones de retina (en casos más avanzados)
- Glaucoma en algunos casos (más frecuente en
gatos)
Gracias a Raquel Udiz y
Visión Veterinaria por las
imágenes

33. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Ojos El ojo es el órgano diana de mayor riesgo, no tanto por la
frecuencia con la que se afecta, sino por la vulnerabilidad de éste
al afectarse.
- Edemas de retina
- Tortuosidad de los vasos de la retina
- Hemorragias retinales
- Desprendimientos de retina (completos o
parciales)
- Secundariamente pueden aparecer
degeneraciones de retina (en casos más avanzados)
- Glaucoma en algunos casos (más frecuente en
gatos)
Gracias a Raquel Udiz y
Visión Veterinaria por las
imágenes

34. Qué es la HAS. Tipos PRIMARIA, SECUNDARIA y ÓRGANO DIANA.
ÓRGANO DIANA
Ojos El ojo es el órgano diana de mayor riesgo, no tanto por la
frecuencia con la que se afecta, sino por la vulnerabilidad de éste
al afectarse.
- Edemas de retina
- Tortuosidad de los vasos de la retina
- Hemorragias retinales
- Desprendimientos de retina (completos o
parciales)
- Secundariamente pueden aparecer
degeneraciones de retina (en casos más avanzados)
- Glaucoma en algunos casos (más frecuente en
gatos)
Gracias a Raquel Udiz y
Visión Veterinaria por las
imágenes

35. ÓRGANO DIANA
Junto con el ojo es el órgano diana más importante.
Renal
LA HIPERTENSIÓN GENERA DAÑO RENAL
EL DAÑO RENAL ENGENDRA HIPERTENSIÓN
J Vet Intern Med 2004;18:289–294
Association of Systemic Hypertension with Renal Injury in Dogs
with Induced Renal Failure
Delmar R. Finco
Systemic hypertension is hypothesized to cause renal injury to dogs. This study was performed on dogs with surgically induced
renal failure to determine whether hypertension was associated with altered renal function or morphology. Mean arterial pressure
(MAP), heart rate (HR), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) were measured before and after
surgery. Glomerular filtration rate (GFR) and urine protein : creatinine ratios (UPC) were measured at 1, 12, 24, 36, and 56–69
weeks after surgery, and renal histology was evaluated terminally. The mean of weekly MAP, SAP, and DAP measurements for
each dog over the 1st 26 weeks was used to rank dogs on the basis of MAP, SAP, or DAP values. A statistically significant
association was found between systemic arterial pressure ranking and ranked measures of adverse renal responses. When dogs
were divided into higher pressure and lower pressure groups on the basis of SAP, group 1 (higher pressure, n 9) compared with
group 2 (lower pressure, n 10) had significantly lower GFR values at 36 and 56–69 weeks; higher UPC values at 12 and 56–
69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, and fibrosis. When dogs were divided on MAP
and DAP values, group 1 compared with group 2 had significantly lower GFR values at 12, 24, 36, and 56–69 weeks; higher UPC
values at 12 and 56–69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, fibrosis, and cell infiltrate.
These results demonstrate an association between increased systemic arterial pressure and renal injury. Results from this study
might apply to dogs with some types of naturally occurring renal failure.
Key words: Canine; Indirect blood pressure; Page–remnant kidney.

36. ÓRGANO DIANA
Junto con el ojo es el órgano diana más importante.
Renal
LA HIPERTENSIÓN GENERA DAÑO RENAL
EL DAÑO RENAL ENGENDRA HIPERTENSIÓN
J Vet Intern Med 2004;18:289–294
Association of Systemic Hypertension with Renal Injury in Dogs
with Induced Renal Failure
Delmar R. Finco
Systemic hypertension is hypothesized to cause renal injury to dogs. This study was performed on dogs with surgically induced
renal failure to determine whether hypertension was associated with altered renal function or morphology. Mean arterial pressure
(MAP), heart rate (HR), systolic arterial pressure (SAP), and diastolic arterial pressure (DAP) were measured before and after
surgery. Glomerular filtration rate (GFR) and urine protein : creatinine ratios (UPC) were measured at 1, 12, 24, 36, and 56–69
weeks after surgery, and renal histology was evaluated terminally. The mean of weekly MAP, SAP, and DAP measurements for
each dog over the 1st 26 weeks was used to rank dogs on the basis of MAP, SAP, or DAP values. A statistically significant
association was found between systemic arterial pressure ranking and ranked measures of adverse renal responses. When dogs
were divided into higher pressure and lower pressure groups on the basis of SAP, group 1 (higher pressure, n 9) compared with
group 2 (lower pressure, n 10) had significantly lower GFR values at 36 and 56–69 weeks; higher UPC values at 12 and 56–
69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, and fibrosis. When dogs were divided on MAP
and DAP values, group 1 compared with group 2 had significantly lower GFR values at 12, 24, 36, and 56–69 weeks; higher UPC
values at 12 and 56–69 weeks; and higher kidney lesion scores for mesangial matrix, tubule damage, fibrosis, and cell infiltrate.
These results demonstrate an association between increased systemic arterial pressure and renal injury. Results from this study
might apply to dogs with some types of naturally occurring renal failure.
Key words: Canine; Indirect blood pressure; Page–remnant kidney.