Survival after diagnosis of hypertension in cats attending primary care practice in the UK

Chang, Y M; Brodbelt, D C; Elliott, J; Conroy, M C

Abstract

Background: Hypertension is common in older cats. There is limited evidence for predictors of
survival after diagnosis.
Hypothesis/Objectives: Investigate blood pressure assessment (BPA) and hypertension diagnosis
in cats attending UK primary care practices (PCPs) and factors that influence survival.
Animals: Cats (347 889) attending 244 UK PCPs enrolled in the VetCompass program between
January 1, 2012, and December 31, 2013. Cats identified as hypertensive (282) were included
in descriptive and survival analyses.
Methods: All electronic patient records (EPRs) were searched to identify cats that potentially
had received BPA. EPRs were read in detail to identify those that had BPA. The proportion that
received BPA was evaluated using a stratified analysis and the incidence of hypertension
estimated. A retrospective cohort study was used to investigate survival after diagnosis (Cox
proportional hazard model).
Results: Estimated incidence risk was 19.5% (95% confidence interval [CI], 17.5-21.6) from the
estimated 1.34% (1.30%-1.38%) of cats that received BPA. Few cats had BPA more than once
after diagnosis (median, 1; interquartile range [IQR], 0-3), with only 9.9% of diagnosed hypertensive
cats having urine protein:creatinine ratio determined. Cats diagnosed as a result of monitoring
of pre-existing disease had improved survival (hazard ratio [HR], 0.58; 95% CI, 0.37-0.89;
P = .01) compared to cats diagnosed after clinical signs were recognized. Cats that had an
amlodipine dose change had improved survival (HR, 0.56; 95% CI, 0.36-0.87; P = .01) compared
to those with no dose change.
Conclusions and clinical importance: These data suggest improved blood pressure monitoring in
clinical practice may decrease the morbidity associated with hypertension.
KEYWORDS
blood pressure, prognosis, feline, VetCompass

Citation

Chang, Y. M., Brodbelt, D. C., Elliott, J., & Conroy, M. C. (2018). Survival after diagnosis of hypertension in cats attending primary care practice in the UK. Journal of Veterinary Internal Medicine, 32(6), 1846-1855. https://doi.org/10.1111/jvim.15307

• Journal Article Type: Other
• Acceptance Date: Jul 24, 2018
• Publication Date: Oct 13, 2018
• Deposit Date: Aug 24, 2018
• Publicly Available Date: Oct 19, 2018
• Journal: Journal of Veterinary Internal Medicine
• Print ISSN: 0891-6640
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: 6
• Pages: 1846-1855
• DOI: https://doi.org/10.1111/jvim.15307
• Public URL: https://rvc-repository.worktribe.com/output/1385618