In the literature
Koo ST, Carr AP. Comparison of home blood pressure and office blood pressure measurement in dogs and cats. Can J Vet Res. 2022;86(3):203-208.
The Research …
Arterial blood pressure (BP) can provide important information about tissue perfusion. Direct BP measurement via catheterization is not practical in routine clinical practice. Indirect measurements with Doppler and oscillometric methods are thus used to estimate pressures. High-definition oscillometric devices can record, display, and store pressure waveforms, allowing for waveform inspection and rejection of readings with inadequate tracings.
Accurate diagnosis of systemic hypertension (ie, systolic BP >160 mm Hg) is challenging but clinically important.1 Several factors (eg, patient breed, age, sex; operator variability) can affect BP measurement in dogs and cats.2 Patients that are stressed or anxious at the clinic may have falsely elevated BP measurements, referred to as white-coat hypertension in human medicine. Many health-related problems (eg, chronic kidney disease, hyperthyroidism, hyperadrenocorticism, diabetes mellitus) can also cause elevated BP.3 Hypertension and underlying causes should be treated, but it is important to consider white-coat hypertension and alternative methods of BP assessment (eg, home measurement) before making clinical treatment decisions.
This study compared BP measurements taken in the clinic with those taken in the home using a high-definition oscillometric device to determine whether dogs (n = 7) and cats (n = 10) were affected by white-coat hypertension (ie, in-clinic systolic BP >160 mm Hg). BP was measured in the clinic with the cuff at the tail base after a 10- to 15-minute acclimation period. Pet owners were instructed to obtain 5 readings at 3 different sessions in the home using the same method as in the clinic. Owners performed 669 recordings (median, 19); 261 (39%) were considered successful after evaluation of the tracings.
Results showed significantly higher BP measurements in the clinic compared with those taken in the home (mean difference systolic, 27.7 mm Hg; mean difference diastolic, 12.9 mm Hg). White-coat hypertension was diagnosed in 41% of patients. The authors concluded that BP measurement in the home may be a practical way to reduce unwarranted diagnosis of hypertension and unnecessary medical intervention caused by white-coat hypertension. Additional prospective studies are needed to understand the prevalence and impact of white-coat hypertension in veterinary patients.
... The Takeaways
Key pearls to put into practice:
Recognizing systemic hypertension in veterinary patients is important but can be challenging because the disease can be primary (eg, idiopathic hypertension), secondary (eg, chronic kidney disease), or caused by environmental stress (eg, white-coat hypertension).
BP measured in the clinic may be elevated due to stress and anxiety. Allowing patients to adjust to their surroundings (eg, placing patients with owners in a quiet room) may help decrease stress before measurement.
BP measurement in the home may help increase confidence in BP readings, more accurately diagnose hypertension, and guide treatment decisions.