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Background  Hypertension is a common problem in older cats, most often associated with chronic kidney disease ( CKD ). Cross‐sectional studies have suggested that blood pressure in cats increases with age.    Hypothesis/Objectives  To determine whether blood pressure in cats increases with age and whether this occurs independently of the presence of  CKD . To investigate risk factors for developing hypertension.    Animals/Subjects  Two hundred and sixty‐five cats with  CKD  and 133 healthy cats ≥9 years were retrospectively identified.    Methods  Four groups were created according to status at initial evaluation ( CKD  or healthy) and blood pressure at the last included visit (normotensive [ NT ] or developed hypertension [ DH ]): Healthy‐ NT , Healthy‐ DH ,  CKD ‐ NT  and  CKD ‐ DH . Systolic blood pressure ( SBP ) over time slopes were compared with 0 and between groups. Risk factors for the development of hypertension were investigated, and associations of biochemical and clinical variables with  SBP  were examined.    Results  Cats that were hypertensive at  CKD  diagnosis (n = 105) were not included in further analyses. Twenty‐seven cats with  CKD  and 9 healthy cats developed hypertension ≥3 months after diagnosis of  CKD  or their first visit. Systolic blood pressure significantly increased with age in all cats ( P  < .001). Healthy cats were at less risk than cats with  CKD  to become hypertensive (hazard ratio 0.2,  P  < .001), with creatinine being an independent risk factor for the development of hypertension.    Conclusions and Clinical Importance  The high prevalence of hypertension in azotemic cats in this study shows the importance of monitoring of  SBP  in elderly cats, and in particular in cats with  CKD .

Changes in Systolic Blood Pressure over Time in Healthy Cats and Cats with Chronic Kidney Disease