Secondary hypertension and its treatment in cats

Abstract

Secondary hypertension caused by an underlying disease is common in older cats, especially in those with chronic kidney disease and/or hyperthyroidism. Systolic blood pressure should be measured whenever an associated disease is diagnosed and persistent systolic blood pressure >160mmHg should prompt treatment to prevent or reverse target organ damage. Amlodipine and telmisartan are licensed in the UK to treat feline hypertension and both drugs have been evaluated in prospective randomised placebo-controlled clinical trials in hypertensive cats with systolic blood pressure of 160–200mmHg that did not have evidence of target organ damage. Initial reductions of 20–30mmHg can be expected with either medication, and cats should be re-evaluated after 14 days and dose adjustments made as required. No studies have compared the performance of one drug against the other and either medication should be selected as the first-line treatment for feline hypertension. At present, there are more data in the literature to support the use of amlodipine in cats with severe hypertension (systolic blood pressure >200mmHg), or with evidence of ocular or neurological target organ damage.