Hypertension (HT) and the associated risk of target organ damage (TOD) is a well-recognized cardiovascular problem of elderly cats. Consequently, early recognition and treatment of HT are crucial. This prospective, multicentre, placebo-controlled, blinded study evaluated telmisartan in hypertensive cats diagnosed with systolic blood pressure (SBP) ≥160 mm Hg on two days. HT causes were classified as chronic kidney disease (CKD), controlled hyperthyroidism, both combined and idiopathic. Cats with SBP >200 mm Hg, evidence of TOD or pre-treated with vasoactive substances were excluded. Cats were randomized (2:1 ratio) to either receive 2 mg/kg telmisartan oral solution, or placebo q 24 h. The study consisted of a 28-day efficacy phase and a 120-day extended-use phase. Efficacy of telmisartan was defined a priori as significant mean SBP-reduction on day 14 compared to placebo and >20 mm Hg SBP population mean reduction on day 28 compared to baseline. Pre-defined post-inclusion removal criteria were adverse events, withdrawal of owner consent, owner non-compliance, TOD and SBP >200 mm Hg. Missing SBP data were imputed in the database using the last observation carried forward method, if removal reasons had been TOD or SBP >200 mm Hg. Data are presented as mean±1SD.

The efficacy population included 174 telmisartan and 88 placebo cats. Age, body weight, breed distribution, HT causes, and baseline SBP were similar in both groups (baseline SBP: telmisartan-group: 179 (±9.9) mm Hg; placebo-group: 177 (±10.1) mm Hg). Telmisartan treatment gave rise to a significantly larger reduction in mean SBP (relative to baseline) when compared to placebo on day 14 (-19±22.0 mm Hg, n=174 vs -9±17.7 mm Hg, n=88; p<0.0001). At day 28, the data from 9 and 1 cats were excluded and that of 2 and 2 cats were imputed giving reduction in SBP relative to baseline of -25±22.8 mm Hg, (n=165) and -11±16.4 mm Hg (n=87) for the telmisartan and placebo groups, respectively. The proportion of cats with SBP reduction >20 mm Hg between baseline and day 28 was 27.6% in the placebo group and 54.6% in the telmisartan group. The mean SBP decrease in the telmisartan group on day 120 was 28±26.9 mm Hg relative to baseline (n=144). Adverse events were evenly distributed in both groups during the efficacy phase and were as would be expected for elderly cats suffering from CKD and other diseases of ageing in the extended-use phase.

In conclusion, telmisartan oral solution was safe and significantly reduced SBP by a clinically relevant magnitude in hypertensive cats for the 4-month study period.

Disclosures

Disclosures to report
Study was planned, organized and financed by Boehringer Ingelheim.