Candesartan not working?

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Brava210

Brava210

Well-Known Member
Relationship to Diabetes
Type 1
Hi,
I have been on 8mg of candesartan for 4 years or so, but BP has been rising recently.
GP changed this to 16mg - 4 weeks on and BP had not changed.
Another GP visit, and this was raised to 32mg, 8 days later now and still no change, in fact it's gone up
Currently running around 169/89.
GP was reluctant to change me to a "Pril" as I am not suffering any side effects.

Any ideas?

Many thanks
 
Many people find a low carb diet reduces BP to the point that some people have to reduce or stop their BP medication. Obviously if you tried that you would need to reduce your bolus insulin accordingly.
 
My Daily intake is basically the same everyday.....

Porridge with blueberries.

Small jacket potato with cottage cheese and salad.

a few nuts in the evening.

No Crisps, Bread, biscuits, chocolate, any fats etc.


So I think that's quite reasonable.
 
I was on a "pril" for many years but suffered the "pril" cough. It was so bad my fellow workers complained about me, not appreciating I really could not control the cough. I was then tried on a "sartan" and that had very bad side effects too. Now I take Amlodipine and Doxazosin with no side effects, and they have worked really well in getting my BP down. So there are other drugs out there your GP might consider, as long as they are not contra-indicated with your current medications.
Do you home monitor? I do, as I suffer from white coat syndrome and can guarantee that my BP will be in the 200/100 range at the surgery, 10 minutes after testing around 130/80 at home! I now measure 4 times a day for 3 weeks, twice a year, at home.
 
Yes I do home monitor I suffer white coat hypertension too.
Candesartsn just seems to do nothing for me.
 
There are a huge number of blood pressure medications and it does seem to be very hit and miss as to what or what combination works for people.
I am on 5mg amlodipine but it was increased to 10mg and I felt unwell, the GP then changed it it Losartan 25mg but I didn't feel good so I cut them in half and was taking 12.5mg but the GP said I couldn't do that and changed to candesartan 2mg which have been OK together with the 5mg amlodipine. But I do get a tickly cough.
My other half has Losartan, quite a high dose and felodipine but does get a terrible tickly cough. He also takes bisoprolol and apixaban. He hates taking all those meds and periodically fiddles about with the various combinations.

It may be there is something which will work better for you, it is certainly worth asking.
I have seen reports that blood pressure meds work more effectively if taken in the evening but it probably depends on the individual.
 
I'm on candesartan, but I've had mine reduced from 16mg to 8mg as hospital found they were affecting my kidneys, so now I am having to monitor my BP. My GP also told me that there have been reports that it works better if taken at night, and my COPD nurse said the same this past week - so this is what I'm doing now.
I think it best if you check your BP at various times throughout the day - also the position you are in can have an effect ie lying down, sitting, standing, on left side etc can all show different readings (so I was told many years ago) - and trying to relax said arm or wrist is not always as easy as we hope it will be!! I often do 3 readings one after another and then log the lowest one.
I have to take my readings with me next time I see my nurse and we'll see how it goes.
The hospital wouldn't change my BP tablet, they thought of changing it to one beginning with an "A", but because I get bad reactions, including anaphylaxis, from various medications, they decided to keep me on it for now. Mine can be in the 160s until the pill takes effect, then it can be in the 130s - my GP said she wants it under 140.
I hope you get it sorted or that they can find an alternative for you.
Do let us know how you get on.
 
NICE hypertension diagnosis and treatment guidelines: https://www.england.nhs.uk/london/wp-content/uploads/sites/8/2019/11/NICE-NG136-Visual-Summary.pdf

And a handy NICE patient decision aid: https://www.nice.org.uk/guidance/ng...medicines-patient-decision-aid-pdf-6899918221

Really, you need to speak more about it with yr doc or specialist; nobody here has the qualifications or knowledge to give you advice. Generally guidelines say add different drugs together with lifestyle mods if needed to keep BP within targets, up to about 4 different classes.

But that may or may not be correct for you & in your situation I'd really want to get a handle on why BP has been going up after apparently being stable for several years. Good luck!
 
Thsankyou everybody,
I take my BP twice daily.
It's just odd that increase from 8mg to 32mg, has made no difference.
I have a phone chat with pharmacist next week, do I will check with them.
I sm stressed about it not going down too.
 
Brava210 said:
Thsankyou everybody,
I take my BP twice daily.
It's just odd that increase from 8mg to 32mg, has made no difference.
I have a phone chat with pharmacist next week, do I will check with them.
I sm stressed about it not going down too.
Click to expand...
The problem is that stress will not help as being stressed often raises blood pressure.
 
That's true.
My latest Cholesterol test was high too.
GP said she doesn't want to medicate for it until BP comes down.

Gary
 
Brava210 said:
Thsankyou everybody,
I take my BP twice daily.
It's just odd that increase from 8mg to 32mg, has made no difference.
I have a phone chat with pharmacist next week, do I will check with them.
I sm stressed about it not going down too.
Click to expand...

Brava - what sort of level is your BP running at?

If it is going up and up, I'd be inclined to ask the Doc to investigate why, not just reach for the prescription pad. Has anything changed in your life, like routines, stress, sleep, weight or whatever? It's amazing what can impact BP.

In your shoes, I'd also be interested in having the 24-hour monitor. It's a pain and so annoying overnight, but at least it would clarify whether your white coat syndrome is also transferring to the use of your home monitor; especially if you are not seeing the desired readings.

Of course, if your meds were working for you and your readings weren't representative of your "real" numbers, you would be experiencing symptoms of low blood pressure, which you don't mention.

Yes, I'd want a better explanation that just continually upping the meds, even if that transpired to be the solution in the end.
 
AndBreathe said:
Brava - what sort of level is your BP running at?

If it is going up and up, I'd be inclined to ask the Doc to investigate why, not just reach for the prescription pad. Has anything changed in your life, like routines, stress, sleep, weight or whatever? It's amazing what can impact BP.

In your shoes, I'd also be interested in having the 24-hour monitor. It's a pain and so annoying overnight, but at least it would clarify whether your white coat syndrome is also transferring to the use of your home monitor; especially if you are not seeing the desired readings.

Of course, if your meds were working for you and your readings weren't representative of your "real" numbers, you would be experiencing symptoms of low blood pressure, which you don't mention.

Yes, I'd want a better explanation that just continually upping the meds, even if that transpired to be the solution in the end.
Click to expand...
Hi,

I had a 24 hour device around 7 years ago and it was deemed OK.
It's currently at about 175/89.
I check it morning and afternoon.
I have been signed off work until its come down too.
 
Brava210 said:
Hi,

I had a 24 hour device around 7 years ago and it was deemed OK.
It's currently at about 175/89.
I check it morning and afternoon.
I have been signed off work until its come down too.
Click to expand...
I assume you take 3 readings, my GP wanted to see all the 3 rather than giving them the average. I always find mine can go 10 or more lower between the first and last.
It may be time to ask for the 24hr monitor again.
 
Hi,
I take 2 readings per sitting and give the lowest.

Gary
 
Brava210 said:
Hi,

I had a 24 hour device around 7 years ago and it was deemed OK.
It's currently at about 175/89.
I check it morning and afternoon.
I have been signed off work until its come down too.
Click to expand...
Hi. It might be worth mentioning that my wife had an iron infusion in Cambridge by an anaesthetist from Papworth hospital and he said that the second number i.e. your 89 was far more important than the larger number. Few seem to know this but he presumably does. He explained the way the heart works to justify what he said. So bear this in mind.
 
Thankyou.
 
I had a nice phone call from Pharmacist last week to see how the Med increase was going.
They suggested waiting another week, which I now have.
Today's reading was 188/89.
Not great.
 
High time your doc tried to find out why your BP has shot up, eg do an ECG for starters I should think.
 
Update..

Went back to GP today to check things, BP was 188/104..😳

Doc has now added 5mg Amlodipine to my 32mg Candesartan

I had another call from pharmacist last week too, to check up on me.
I thought this was really nice until.....

I said my morning reading was 192/94........She said "That's absolutely fine"

WHAT!
 
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