title: Effect of control of systolic blood pressure on survival in cats with systemic hypertension.
abstract: BACKGROUND
  Systemic hypertension is a common clinical problem, often occurring in association with renal disease in cats. Limited information is available to assess the effect of blood pressure and the treatment of hypertension on survival.
  
  
  OBJECTIVE
  That adequacy of blood pressure control is associated with the duration of survival in cats with systolic hypertension.
  
  
  METHODS
  One hundred and forty-one client-owned cats with systolic hypertension.
  
  
  METHODS
  Hypertensive cats were treated with amlodipine besylate and were followed until death or the study end point. Time-averaged systolic blood pressure (SBPOT) after implementation of antihypertensive medication and stabilization of systolic blood pressure (SBP) was calculated by using the equation (area under the curve/survival [days]). Cats were divided into quartiles based on their SBPOT, representing varying levels of blood pressure control (median [25th, 75th percentile]: Q1 = 137 [132, 141] mm Hg, Q2 = 148 [145, 151] mm Hg, Q3 = 157 [155, 158] mm Hg, Q4 = 170 [164, 175] mm Hg). Survival and clinical variables were compared between the quartiles. Cox proportional hazard regression analysis was used to determine the association of age, renal function, proteinuria, SBPOT, and the presence of hyperthyroidism on survival. Urine protein to creatinine ratio (UP:C) was compared at diagnosis of hypertension and after initiating treatment.
  
  
  RESULTS
  Only UP:C and SBP at diagnosis differed significantly between SBPOT quartiles. Proteinuria was the only variable significantly related to survival in hypertensive cats. A significant decline in UP:C was found in cats treated with amlodipine besylate.
  
  
  CONCLUSIONS
  Proteinuria before and after treatment of hypertension is strongly associated with survival in cats with systolic hypertension. Treatment with amlodipine besylate can result in a significant reduction in UP: C.
authors.affiliation: Department of Veterinary Basic Science, Royal Veterinary College, Camden, London, UK. rjepson@rvc.ac.uk
authors.forename: Rosanne E
authors.initials: RE
authors.lastname: Jepson
authors.forename: Jonathan
authors.initials: J
authors.lastname: Elliott
authors.forename: David
authors.initials: D
authors.lastname: Brodbelt
authors.forename: Harriet M
authors.initials: HM
authors.lastname: Syme
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use*; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D019540:Area Under Curve; D002371:Cat Diseases / Q000188:drug therapy* / Q000401:mortality / Q000652:urine; D002415:Cats; D003404:Creatinine / Q000652:urine; D005260:Female; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality / Q000652:urine / Q000662:veterinary*; D008297:Male; D016016:Proportional Hazards Models; D011507:Proteinuria / Q000150:complications / Q000662:veterinary*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D017311:Amlodipine; D003404:Creatinine