Prevalence of Systemic Hypertension and Control of Systolic Blood Pressure in a Cohort of 14 Dogs with Adrenal-Dependent Hypercortisolism during the First Year of Trilostane Treatment or after Adrenalectomy

Abstract

Hypercortisolism in dogs is frequently associated with systemic hypertension (SH). However, there are no studies evaluating the changes in systolic blood pressure (SBP) in dogs with adrenal-dependent hypercortisolism (ADH) during trilostane treatment or after adrenalectomy and their response to antihypertensive treatments. For this reason, the objectives of this study were to evaluate the changes in SBP in dogs with ADH during the first year of trilostane treatment or after adrenalectomy, the relation with clinical control of hypercortisolism and certain laboratory parameters, and the response to antihypertensive drugs. Fourteen dogs newly diagnosed with ADH were prospectively included and evaluated at diagnosis (T0) and 1, 3, 6, and 12 months after (T1, T3, T6, and T12, respectively). Dogs were classified as hypertensive (HT; SBP ≥ 160 mmHg) and non-hypertensive. In HT dogs, benazepril was considered as the first-line drug, and, if necessary, amlodipine was prescribed. The prevalence of SH at T0 was 79%, and it was reduced to 25% at T12. Blood pressure (BP) was not associated with disease control or selected laboratory parameters at any endpoint. Only 22% of dogs with SH needed more than one drug to normalize their SBP. In all dogs surgically treated that were HT at T0, BP normalized at T3.

Simple Summary: Cushing’s syndrome is a common disease in middle-aged and old dogs, characterized by steroid overproduction by the adrenal glands. This steroid excess can be caused by an adrenal tumor (adrenal dependent hypercortisolism) and is associated with systemic hypertension. In people with this disease, it is known that hypertension can be difficult to manage and, sometimes, several drugs are necessary to treat it. However, there are no studies focused on the changes in the blood pressure during treatment in dogs with adrenal-dependent hypercortisolism. In this study, 14 dogs with this disease were followed during the first year of medical treatment or during 1 year after surgery to remove the adrenal tumor (adrenalectomy), and the changes in their blood pressure were evaluated. We observed that blood pressure in medically treated dogs decreased during the study period using, in most cases, a single antihypertensive drug. Also, in those dogs surgically treated, blood pressure normalized three months after surgery, and in one case, antihypertensive medications could be reduced. Thus, when adrenalectomy is performed, it is important to carefully address blood pressure after the procedure as these dogs might require reductions in their antihypertensive treatment.