Prevalence and risk factors associated with systemic hypertension in dogs with spontaneous hyperadrenocorticism

• Published in: Journal of veterinary internal medicine 2020-09, Vol.34 (5), p.1768-1778
• Main Authors: García San José, Paula, Arenas Bermejo, Carolina, Clares Moral, Irene, Cuesta Alvaro, Pedro, Pérez Alenza, María Dolores
• Format: Article
• Language: English
• Subjects: Blood pressure; canine; Confidence intervals; cortisol; Creatinine; Cushing; Density; Diabetes; Hormones; hypercortisolism; Hypertension; Kidney diseases; Multivariate analysis; Normal distribution; Pediatrics; Risk factors; SMALL ANIMAL; Ultrasonic imaging; Urinalysis
• ISSN: 0891-6640; 1939-1676
• DOI: 10.1111/jvim.15841

Background Systemic hypertension (SH) is common in dogs with hyperadrenocorticism (HAC) however there are not many studies assessing its prevalence and risk factors. Objectives To determine the prevalence and severity of SH in dogs with HAC and its association with clinical and laboratory findings to identify potential risk factors. Animals Sixty‐six client owned dogs with spontaneous HAC. Methods Retrospective cross‐sectional study. Medical records of dogs with HAC were reviewed. Systolic blood pressure (SBP) was measured using Doppler ultrasonography. Clinical signs, physical examination findings and clinicopathologic data (CBC, serum biochemistry and electrolytes, urinalysis and urinary culture, and adrenal function tests) were reviewed for analysis. Results Prevalence of SH (≥150 mm Hg) was 82% (54/66) and prevalence of severe SH (≥180 mm Hg) was 46% (30/66). All dogs with thrombocytosis had SH (P = .002), and a platelet count ≥438 × 103/μL was 100% specific and 61.1% sensitive to predict SH (AUC = .802, P = .001). Median potassium levels were lower in hypertensive dogs (4.1 mEq/L, range 3.1‐5.4 mEq/L) than in normotensive ones (4.5 mEq/L, range 4.0‐5.0 mEq/L) (P = .007). Dogs with UPC ≥ 0.5 had higher median SBP than those without proteinuria (P = .03). Dogs with concurrent diabetes mellitus seemed to have a reduced risk of SH (OR = .118, 95%CI = .022‐.626, P = .02). Conclusions and Clinical Importance Systemic hypertension is common in dogs with HAC and is frequently severe. Blood pressure should be routinely assessed in these dogs, especially if thrombocytosis, proteinuria or low potassium concentrations are present.