Hypertension

Question 1

What are common reasons cats develope hypertension

Answer 1

Increased vascular tone, local RAAS activation, inappropriate Na handling with CKD, Increased catecholamines or decreased SVR → RAAS in hyperthyroidism

Question 2

What percentage of cats with hypertension will develop primary or secondary and what is the most common form of secondary ?

Answer 2

• 20% of cats will ve primary
• 80% secondary

CKD is the most common cause

Question 3

What percentage of cats with CKD will be hypertensive and how what percentage of cats with hypertension have CKD?

Answer 3

• 74% of cats with hypertension have CKD
• 65% of cats with CKD have hypertension

Question 4

draw a diagram for the management of hypertension?

Answer 4

Question 5

Draw a diagram describing the pathways for taken once the need for hypertensive therapy is established?

Answer 5

Question 6

What are the findings of Coleman et al Safety and efficacy of orally administered telisartan for the treatment of systemc hypertension in cats: results of a double blind, placebo controlled , randomized clinical trial?

Answer 6

Key findings include:

• Telmisartan significantly reduced systolic blood pressure (SBP) compared to placebo. By day 14, telmisartan-treated cats had an average SBP reduction of 23.3 mm Hg, while placebo-treated cats only saw a 7.5 mm Hg reduction.
• By day 28, the reduction in SBP remained significant and clinically relevant (23.9 mm Hg), while the placebo group only had a reduction of 11.6 mm Hg.
• Telmisartan was well tolerated in cats over the course of the study, with the SBP reduction persisting throughout the 6-month trial​

12.0% of telmisartan- and 10.4% of placebo-treated cats experiencing serious adverse events

Question 7

What are the key take awsys from the Bijsmans et al article factors influencing the relationship between the dose of amlodipine required for blood pressure control and change in blood pressure in hypertensive cats

Answer 7

Initial SBP Impact: Cats with a higher initial SBP required a higher dose of amlodipine to achieve effective blood pressure control. Cats with an initial SBP around 207 mm Hg required 1.25 mg/day of amlodipine, while those with lower SBP around 182 mm Hg were controlled with 0.625 mg/day.

Potassium Levels: Cats needing higher doses of amlodipine had lower plasma potassium levels. This suggests potential links between potassium concentrations and the dose of medication required for blood pressure control, though more studies are needed to clarify this relationship.

Amlodipine Pharmacokinetics: The study found that the plasma concentration of amlodipine was directly proportional to the dose given, similar to findings in humans and other animals. This rules out variability in drug absorption or owner compliance as significant factors affecting blood pressure response.

No Renin-Angiotensin System Link: Unlike in humans, no strong connection was found between hypertension and the renin-angiotensin-aldosterone system in cats, suggesting that other mechanisms, possibly related to chronic kidney disease (CKD), play a larger role in feline hypertension.