Telmisartan in cats with systemic hypertension

Pathological increases in blood pressure may lead to ophthalmic, cardiovascular and neurological injuries and, in old cats, systemic arterial hypertension is indeed an important cause of morbidity. Drugs like telmisartan, a nonpeptide angiotensin II receptor blockers, are used in human medicine due to their antihypertensive and cardiovascular protection effects. The investigation aimed to evaluate the safety and efficacy of administering an oral solution of this medication for decreasing systolic arterial blood pressure (SBP) in cats with spontaneous hypertension.

The study included 221 cats that were assigned to one of four subpopulations: CKD (Chronic Kidney Disease), hyperthyroidism, CKD and hyperthyroidism, or idiopathic HT (hypertension). For 28 days, a telmisartan solution (4 mg/ml) was administered to 142 of the cats and an equivalent volume of a visually identical placebo was administered to the remaining 79 animals. In the first 14 days, the dosage was 1.5 mg/kg q12h and afterwards it was changed to 2 mg/kg daily.

On average, treatment with telmisartan resulted in a persistent decrease of systolic arterial blood pressure of approximately 23 mmHg by the fourteenth day of treatment. In 52.1% of the cats inthis group, SBP decreased to below 150 mmHg, or by at least 15% of baseline. Interestingly, a reduction of approximately 7 mmHg, was also noticed in 19% of the individuals from the placebo group. This might be explained by the potential acclimatization of the cats to the BP measurement process or to daily handling (and, therefore, the decrease on the “white-coat” effect) or by an unconscious change in the approach to the BP measurement within the staff members.

This study concluded that telmisartan is a possible valuable treatment for cats with systemic hypertension. When administered at the dosage used in this trial, telmisartan is well tolerated by cats with CKD of IRIS stages 1-3 and geriatric. Though, it is important to consider the admission criteria of this investigation as, for example, cats with severe renal azotemia were not included.

Coleman, AE, Brown, SA, Traas, AM, Bryson, L, Zimmering, T, Zimmerman, A. Safety and efficacy of orally administered telmisartan for the treatment of systemic hypertension in cats: Results of a double‐blind, placebo‐controlled, randomized clinical trial. J Vet Intern Med. 2019; 33: 478– 488. https://doi.org/10.1111/jvim.15429