Angiotensin-II receptor antagonists (candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan) are used in the treatment of hypertension. Irbesartan and losartan may also be used to treat renal disease in hypertensive type 2 diabetes, valsartan may be used post-myocardial infarction, and eprosartan for heart failure if an ACE inhibitor is not tolerated.

Dosage regimen

* Angiotensin-II receptor antagonists are usually started at a low dose, then increased every couple of weeks if necessary. They are usually taken once daily.

Patient's knowledge of the medicine's use

* Angiotensin-II receptor antagonists are used for range of cardiovascular conditions, may of which are "silent". To improve compliance, explain to the patient why it is important to continue taking the medicine regularly.

Is the medicine working?

* Has the patient been taking the correct dosage of their medication?

* Has the patients symptoms/condition deteriorated? If so, refer back to the prescriber.

* Is the patient taking any OTC/herbal remedies, which may interact with their medication?

Side effects

* Side effects of angiotensin-II receptor antagonists are usually mild, but can include hypotension, dizziness, angioedema and occasional hyperkalaemia.

Monitoring

* Blood pressure should be monitored regularly. Some patients may also need regular potassium level checks.

Lifestyle

* Patients with cardiovascular conditions often benefit from regular aerobic and/or resistive exercise and quitting smoking and may be eligible for a "one-off" pneumococcal vaccination and a yearly flu vaccination.

* Patients on ACE inhibitors should be advised to avoid salt substitutes as these are likely to be potassium-based and may contribute to hyperkalaemia.

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