Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Iodocat, Madrid, Spain.
J Vet Intern Med. 2024 May-Jun;38(3):1359-1369. doi: 10.1111/jvim.17032. Epub 2024 Mar 5.
Hyperthyroid cats commonly have systemic hypertension, with a reported prevalence of 7% to 48%. Although hypertension might be expected to resolve once treatment restores euthyroidism, it can persist or only first develop after treatment.
To determine the proportion of hyperthyroid cats with hypertension (systolic blood pressure [SBP] ≥160 mm Hg), persistence or first development of hypertension after successful radioiodine treatment, and correlation of post-treatment hypertension with azotemia or hypothyroidism.
Four hundred one hyperthyroid nonazotemic cats were included in the study.
Prospective, cross-sectional and before-and-after studies. All hyperthyroid cats had SBP measured by Doppler; 255 had SBP rechecked 6 months after successful radioiodine (I) treatment.
Of untreated hyperthyroid cats, 108/401 (27%) were hypertensive. A higher proportion of hypertensive cats were nervous/excited compared with normotensive cats (47% vs 12%; P < .001). Of the initially hypertensive cats, 87/108 cats were reexamined after I treatment; 43/87 (49%) cats normalized SBP, whereas 44/87 (51%) remained hypertensive. Of the initially normotensive cats, 16/168 (9.5%) first developed hypertension after successful I treatment. 7/60 (12%) of the I-treated hypertensive cats were azotemic and 9/60 (15%) were hypothyroid. A higher proportion of cats remaining hypertensive had nervous/excited demeanor than did normotensive cats (50% vs 17%; P < .001).
CONCLUSIONS/CLINICAL IMPORTANCE: Hypertension, when present, resolves in many hyperthyroid cats after successful treatment. Hyperthyroid cats uncommonly develop new hypertension after treatment. Persistent or newly detected hypertension was unrelated to azotemia or iatrogenic hypothyroidism. More frequently perceived nervousness/anxiety in radioiodine-treated hypertensive cats suggests that many of these cats might have "situational" hypertension, as hyperthyroid-induced hypertension should resolve after treatment.
患有甲状腺功能亢进的猫通常会出现全身性高血压，其发病率为 7%至 48%。尽管在治疗后恢复甲状腺功能正常时，高血压可能会得到缓解，但它也可能持续存在，或者仅在治疗后首次出现。
确定患有高血压（收缩压[SBP]≥160mmHg）的甲状腺功能亢进猫的比例、成功放射性碘治疗后高血压的持续或首次出现情况，以及治疗后高血压与氮质血症或甲状腺功能减退的相关性。
本研究纳入了 401 只非氮质血症的甲状腺功能亢进猫。
前瞻性、横断面和前后对照研究。所有甲状腺功能亢进猫均通过多普勒测量收缩压；255 只猫在成功接受放射性碘（I）治疗后 6 个月复查收缩压。
在未经治疗的甲状腺功能亢进猫中，有 108/401（27%）患有高血压。与血压正常的猫相比，高血压猫更易表现出紧张/兴奋（47%比 12%；P<.001）。在最初患有高血压的猫中，有 87/108 只在 I 治疗后接受了复查；43/87（49%）只猫的收缩压恢复正常，而 44/87（51%）只猫仍患有高血压。在最初血压正常的猫中，有 16/168（9.5%）只在成功接受 I 治疗后首次出现高血压。在接受 I 治疗的高血压猫中，有 7/60（12%）只患有氮质血症，有 9/60（15%）只患有甲状腺功能减退。与血压正常的猫相比，持续存在高血压的猫表现出紧张/兴奋的比例更高（50%比 17%；P<.001）。
结论/临床意义：在成功治疗后，许多甲状腺功能亢进猫的高血压得到缓解。甲状腺功能亢进猫在治疗后很少会出现新的高血压。持续性或新出现的高血压与氮质血症或医源性甲状腺功能减退无关。在接受放射性碘治疗的高血压猫中，更多地察觉到紧张/焦虑，这表明其中许多猫可能患有“情境性”高血压，因为甲状腺功能亢进引起的高血压在治疗后应该会得到缓解。
