Candesartan

Candesartan is one of the medicines that can be used to manage high blood pressure (hypertension). It’s also used by some people with heart failure.

If you have high blood pressure, then there is too much strain being put on your blood vessels. This can cause damage in the long-run so medicine like candesartan is used. It stops a hormone called angiotensin-II from working in your blood vessels, which means that your blood vessels relax. This then reduces your blood pressure.

Candesartan is for people with high blood pressure (hypertension). A diagnosis of hypertension is usually made if your blood pressure is 140/90 mmHg or higher. Candesartan can be the preferred choice for some people, but it might not be suitable for everyone.

Candesartan is just one of the many medicines used to manage blood pressure. It may be recommended for the following groups of people.

• People under the age of 55 years
• People who are not black (of African or Caribbean origin)
• People that have tried other blood pressure medicines, but are experiencing side effects
• People that have tried other blood pressure medicines, but still have high blood pressure

Candesartan is not usually not recommended for:

• pregnant or breastfeeding women
• people with severe liver problems

Having high blood pressure means that your blood vessels and heart are put under a higher level of stress than they’re used to coping with. The extra strain is also felt by organs such as the brain, kidneys and eyes.

This puts you at higher risk of problems like:

• heart failure – a heart too weak or stiff to pump blood properly
• coronary artery disease – a blockage in the supply of blood to the heart's muscles that can cause angina or a heart attack
• stroke – when blood supply to part of the brain is stopped or restricted
• chronic kidney disease – when the kidneys stop working as they should
• peripheral arterial disease – a blockage in the supply of blood to the legs
• vascular dementia – damage to the brain caused by reduced blood flow

It has been calculated that for every 10 mmHg you're able to lower your blood pressure by, there's a 13% reduction in your chance of dying from any cause.

Yes, you can order candesartan from an online doctor service such as ZAVA. This service is a convenient alternative to your local GP.

Candesartan is a prescription-only medicine. If you choose to order candesartan in person, you’ll need to make an appointment to see your GP. A prescription can then be taken to your pharmacy to dispense the medicine.

If you choose to order candesartan online, you’ll have the opportunity to get an assessment from a doctor without needing a face-to-face consultation. They will be able to assess your condition and background with a view to providing a prescription, providing this is something you have already been established on by your GP or specialist, and to keep having regular follow-up with them. Medicines are sent to your door by post.

The best approach to treating high blood pressure is a combination of medication and lifestyle changes. This is because:

• Lifestyle changes don’t work fast enough to reduce the risk to your health - so medicine works best in tackling the problem quickly
• Medication can lower your blood pressure but won’t cure the cause of your high blood pressure - so lifestyle changes are the best way to help your blood pressure long-term

If you make enough lifestyle changes you might be able to stop taking your medication.

Generally, it’s possible to reduce your blood pressure naturally with lifestyle changes. If your blood pressure is only a little above normal and your doctor is satisfied that you are otherwise healthy, then lifestyle changes alone may be enough to bring your blood pressure down.

However, changes to your lifestyle may not reduce your blood pressure as quickly or effectively as medicine. If you have been diagnosed with hypertension and prescribed medicine, it’s important that you take medicine in addition to any lifestyle changes you've chosen to make.

The reason people are prescribed medicine for their blood pressure is to lower their risk of developing a serious disease which could result in disability or death. Natural methods of decreasing your blood pressure will also reduce this risk, but not as much as both together.

If you're having problems with your medicine and are considering stopping treatment, you should speak with a doctor. They may be able to adjust your dose or switch your treatment to something that suits you better.

Lifestyle changes that you can make that can prevent or lower high blood pressure include:

• eating less salt in your diet
• losing weight if you're overweight
• drinking less alcohol if you drink too much (less than 14 units a week)
• exercising regularly and staying active
• drinking less caffeine (no more than four cups of coffee a day)
• eating less sweets and red meats
• drinking less sugary drinks
• quit smoking if you're a smoker
• getting enough sleep at night

Studies have shown that a diet rich in potassium, calcium, magnesium and fibre, but low in sodium and saturated fat may help in reducing your blood pressure. Try eating things like:

• fruits such as apples or bananas
• vegetables like broccoli, spinach or carrots
• low-fat dairy foods such as Greek yoghurt
• whole-grain foods like brown rice or oatmeal
• lean meats like fish or chicken
• unsalted nuts, beans and seeds

There is some evidence that fish oil supplements can cause a slight reduction in your blood pressure. They’re also thought to reduce your risk of heart and blood problems.

There are many medicines available to manage blood pressure. Usually, your doctor will start you on either an angiotensin-converting enzyme inhibitor (ACE inhibitor) or a calcium-channel blocker (CCB).

If you are younger than 55 years and are not black (of African or Caribbean origin) you are most likely a person with ‘high renin’ so your doctor will usually recommend an ACE inhibitor like:

• enalapril
• lisinopril
• perindopril
• ramipril
• trandolapril

If you are older than 55 years or black then you are likely to be a person with ‘low renin’, so a CCB is usually a better choice than an ACE inhibitor. CCBs include:

• amlodipine
• felodipine
• nifedipine
• verapamil

Candesartan is from a family of drugs called angiotensin-receptor blockers (ARBs). These work in a similar way to ACE inhibitors and are often used as an alternative when a person does not get on well with an ACE inhibitor, for example, if an ACE inhibitor is causing them to cough. Medicines in the ARB family include:

• candesartan
• irbesartan
• losartan
• valsartan

The choice over which ARB is best for you will depend on what other conditions you have and where your doctor thinks you are at highest risk. Candesartan is thought to be better at preventing heart failure, whereas losartan may be better at preventing stroke. Your doctor will be able to recommend a preferred treatment option based on your medical history.

If your blood pressure cannot be managed with just 1 medicine, your doctor’s next step will be to try 2 together. If you’re taking an ACE inhibitor or an ARB, they may add a CCB. Similarly, if you’re taking a CCB, they may add an ACE inhibitor or an ARB.

As with all medicines, there is a risk of experiencing side effects when taking candesartan. You should always read the patient information leaflet before you start taking any new medicine.

It’s possible that candesartan can reduce your number of white blood cells. This means you could be more prone to catching an infection or developing a fever. This would normally be diagnosed using a blood test.

Very rare side effects have also been reported that may affect up to 1 in 10,000 people:

• Swelling of the face, lips, tongue or throat
• Decreased red or white blood cells, which may be experienced as tiredness, infection or fever
• Skin rash, including lumpy rash (hives)
• Itching
• Back pain, or pain in the joints and muscles
• Problems with your liver, which may be experienced as tiredness, yellowing of the skin and eyes, or flu-like symptoms
• Nausea
• Changes in blood test results, including decreased sodium, which may be experienced as weakness, lack of energy, or muscle cramps
• Cough

If you think you may be experiencing side effects, you should speak to your doctor. They may be able to change your dose or prescription to something more suitable.

Many side effects are minor and may pass with time once your body has adjusted to the new treatment. However, if you are experiencing a serious reaction, including a possible allergic reaction, you should stop taking candesartan and see a doctor as soon as possible.