Telmisartan for feline systemic hypertension vs placebo — LIKELY

In hypertensive cats, does telmisartan vs placebo reduce systolic blood pressure to target?

Shelf #248 · gate-verified and displayed under the developer's blinded-trial rule

LIKELY: Telmisartan lowers systolic blood pressure in hypertensive cats, on the strength of two large randomised, double-blind, placebo-controlled trials that agree. In Glaus 2019 (285 cats with systolic arterial blood pressure 160–200 mmHg), telmisartan 2 mg/kg once daily reduced pressure by 19.2 mmHg at day 14 and 24.6 mmHg at day 28 from a baseline of 179 mmHg, versus falls of 9.0 and 11.4 mmHg on placebo from 177 mmHg (day 14 difference P < .001), and 52% of telmisartan cats were below 150 mmHg at day 28. In Coleman 2019 (221 cats), the systolic fall at day 14 was −23.3 mmHg on telmisartan versus −7.5 mmHg on placebo (P = .0005), and at day 28 −23.9 versus −11.6 mmHg. The drug-attributable effect is the between-group difference of roughly 10–16 mmHg; both trials measure blood pressure, not target-organ outcomes, and no mortality or survival claim is made, so this pack is not Tier C. Drafted Nov 10, 2026 (VetMed build, topic #248); all figures from abstracts fetched and verified at drafting.

Glaus 2019: telmisartan cut systolic pressure by 24.6 mmHg at day 28 vs 11.4 mmHg on placebo in 285 hypertensive cats

Prospective, multicenter, placebo-controlled, randomized, double-blinded study (record's own wording)

Who: Cats: 285 client-owned cats with systemic hypertension — systolic arterial blood pressure (SABP) ≥ 160 mmHg and ≤ 200 mmHg, without target-organ damage — in a prospective, multicenter, placebo-controlled, randomized, double-blinded study. Cats were randomized 2:1 to telmisartan 2 mg/kg or placebo, each PO once daily. A 28-day efficacy phase was followed by a 120-day extended use phase; 252 cats completed the efficacy phase and 144 the extended use phase.

Result: Mean SABP reduction at day 14 differed significantly between groups (P < .001). Telmisartan reduced a baseline SABP of 179 mmHg by 19.2 mmHg (95% CI: 15.92–22.52) at day 14 and by 24.6 mmHg (95% CI: 21.11–28.14) at day 28; the placebo group reduced a baseline SABP of 177 mmHg by 9.0 mmHg (95% CI: 5.30–12.80) and 11.4 mmHg (95% CI: 7.94–14.95) at the same time points. Of note, 52% of telmisartan-treated cats had SABP < 150 mmHg at day 28. Mean SABP reduction by telmisartan in severe (≥ 180 mmHg) and moderate (160–179 mmHg) hypertension was comparable and persistent over time. The authors concluded telmisartan oral solution was effective in reducing SABP in hypertensive cats with SABP ≥ 160 mmHg and ≤ 200 mmHg.

Watch out: Cats with target-organ damage were excluded, and cats with SABP above 200 mmHg were outside the studied range — the record does not cover the emergency presentations. The placebo group also fell by about 9–11 mmHg, so the drug-attributable fall is the between-group difference (about 10 mmHg at day 14 and 13 mmHg at day 28), not the full 24.6 mmHg fall on telmisartan. The endpoint is blood pressure itself, not prevention of blindness, kidney progression or death, none of which this record reports.

Glaus TM, Elliott J, Herberich E, Zimmering T, Albrecht B. Efficacy of long-term oral telmisartan treatment in cats with hypertension: Results of a prospective European clinical trial. J Vet Intern Med. 2019;33(2):413-422. PMID: 30561059. Registry ID: none in the record. MeSH: Animals · Antihypertensive Agents · Blood Pressure · Cat Diseases · Cats · Double-Blind Method · Europe · Female · Hypertension · Male · Prospective Studies · Random Allocation · Telmisartan · Treatment Outcome

Coleman 2019: telmisartan cut systolic pressure by 23.3 mmHg at day 14 vs 7.5 mmHg on placebo (P = .0005) in 221 hypertensive cats

Multicenter, prospective, randomized, double-blind, placebo-controlled, parallel group trial (record's own wording; the article title also states double-blind, placebo-controlled, randomized)

Who: Cats: 221 client-owned cats with indirect systolic arterial blood pressure (SBP) of 160–200 mmHg, based on multiple measurements, in a multicenter trial with a 28-day prospective, randomized, double-blind, placebo-controlled, parallel group efficacy phase and a 154-day extended-use telmisartan phase. Hypertensive cats were randomly assigned to telmisartan 1.5 mg/kg PO every 12 hours for 14 days followed by 2 mg/kg PO once daily, or an equivalent volume of placebo; SBP was measured on days 0, 14 and 28.

Result: On day 14, the least squares mean (95% CI) SBP decrease was significantly larger in telmisartan-treated cats (−23.3 mmHg [−28.2 to −18.3]) than in placebo-treated cats (−7.5 mmHg [−13.6 to −1.5]) (P = .0005). On day 28, telmisartan treatment resulted in a clinically relevant SBP decrease (−23.9 mmHg [−27.8 to −20.0]) — clinically relevant defined in the record as a decrease of more than 20 mmHg — whereas placebo did not (−11.6 mmHg [−17.4 to −5.9]). The decrease in SBP persisted over the 6-month trial in telmisartan-treated cats, and telmisartan was well tolerated.

Watch out: The dosing regimen differs from the Glaus trial (a 14-day twice-daily lead-in at 1.5 mg/kg before 2 mg/kg once daily, versus 2 mg/kg once daily from the start), so the two trials support the drug and the 2 mg/kg daily maintenance dose rather than one exact starting protocol. As in Glaus, the studied range is 160–200 mmHg and the endpoint is blood pressure, not target-organ outcomes.

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(2):478-488. PMID: 30851066. Registry ID: none in the record. MeSH: Animals · Antihypertensive Agents · Blood Pressure · Cat Diseases · Cats · Double-Blind Method · Female · Hypertension · Male · Prospective Studies · Random Allocation · Telmisartan · Treatment Outcome

Synthesis: two large, independent, blinded placebo-controlled trials agree — telmisartan lowers feline systolic pressure by roughly 10–16 mmHg more than placebo

Synthesis

Who: Synthesis of the cards above: Glaus 2019 (prospective, multicenter, placebo-controlled, randomized, double-blinded European trial; 285 cats) and Coleman 2019 (multicenter, randomized, double-blind, placebo-controlled trial; 221 cats).

Result: Both trials enrolled cats with systolic pressure of 160–200 mmHg, both used a 28-day blinded placebo-controlled phase, and both found a significant separation by day 14 that persisted: telmisartan falls of 19.2–24.6 mmHg (Glaus) and 23.3–23.9 mmHg (Coleman) against placebo falls of 7.5–11.6 mmHg. That concordance across two large blinded trials is why this shelf is LIKELY. It is a blood-pressure shelf, distinct from shelf #249 (amlodipine vs placebo for the same condition) and from shelf #247 (telmisartan vs benazepril for proteinuria): it shows telmisartan controls pressure, and neither trial measures whether that prevents retinal, renal or other target-organ harm. No mortality or survival claim is made, so this pack is not Tier C.

Watch out: Both trials come from the manufacturer's telmisartan programme (Zimmering T is an author on both records), enrolment stopped at 200 mmHg, and the extended-use phases after day 28 are uncontrolled — the LIKELY stamp rests on the two blinded 28-day phases, not on the open follow-up.

Synthesis of Glaus TM et al. PMID: 30561059; Coleman AE et al. PMID: 30851066. Registry IDs as on the individual cards.

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