Cross Examination of Atenolol and Canderstan Cilexetil on the

Treatment of Hypertension

Mingxuan Yang

BASIS International School Shenzhen, Shenzhen, Guangdong, 518067, China

Keywords: Hypertension (HTN), Atenolol, Canderstan Cilexetil/Canderstan, Beta-1 Adrenergic Receptor, Angiotensin

II Receptor (Type-1).

Abstract:

Hypertension is a serious medical condition that has led to approximately a total of 7.6 million deaths annually

throughout the globe. In retrospect of the entire medical history, many drugs had been used for the treatment

of hypertension, but none had presented a consummate solution that could eradicate or prevent hypertension

previously at all. Nowadays, with the fast-developing medical industries, people can gain access to more

medications targeting hypertension with a far wider range of scope and through more convenient facilitations.

Drugs such as atenolol and canderstan cilexetil had furthermore also became some of the most popular drugs

used to treat high blood pressure with the precondition of a prospering modern medical market. In order to

resolve one of the most difficult medical problems that hovered through the entire human history until now,

it is essentially necessary to understand what is the best equipment that can defeat the abhorrent enemy in the

entire medical field----hypertension.

1 INTRODUCTION

Hypertension (HTN), commonly known as high

blood pressure (HBP) by the public, is often

considered as one of the most dreadful causes of

cardiovascular dysfunction as it induces to

approximately 54% of all stroke diagnoses and 47%

of all coronary heart diseases discovered world-

widely (

J;, A. H. B. F. C, 2011)

. As the culprit

contributing to a total of 7.6 million deaths annually

throughout the globe, HTN has the highest mortality

rate in comparison to any other risk factors for

cardiovascular diseases or kidney failures (

J;, A. H.

B. F. C, 2011)

. Overall, 80% of diagnoses for HTN

were found in low- and middle-income countries (

J;,

A. H. B. F. C, 2011)

, making it a great struggle

related to poverty and population aging also since the

population of age 69 and older would have the

possibility to be diagnosed with HTN with a 50%

chance, much higher in comparison to a 38% for the

younger age group (

GL;, O. R. V. B. (n.d.)

. As

partially shown in Table 1, in China, an average of

23.2% of the adult population during 2012-2015 was

diagnosed with HTN, while another 41.3% of the

entire Chinese adult group were discovered to have

symptoms indicating pre-HTN, demonstrating a high

prevalence for HTN in China and throughout the

globe (

Wang, 2018)

Table 1: Trend of hypertension prevalence in Chinese adults from year 2007-2015 [3-4].

Years 2007 2009 2010 2011 2013 2015

Prevalence (%) of HTN in Chinese adult

population

26.6 29.6 33.5 22.8 24.5 37.2

According to the American College of

Cardiology/American Heart Association Guideline

for the Prevention, Detection, Evaluation, and the

Management of High Blood Pressure in Adults,

systolic HTN is confirmed once one’s blood pressure

has reached 130 mm Hg or higher, while diastolic

HTN would be confirmed once the patient’s blood

level has reached 80 mm Hg or higher (

Whelton,

2017)

. Patients diagnosed with HTN were often

found to be accompanied by symptoms including

extensive nose bleeding, dizziness, or shortness of

breath when their blood pressure has reached a high

life-threatening stage while demonstrating minor or

no symptoms during normal-day activities (

Mayo

Yang, M.

Cross Examination of Atenolol and Canderstan Cilexetil on the Treatment of Hypertension.

DOI: 10.5220/0011381300003443

In Proceedings of the 4th International Conference on Biomedical Engineering and Bioinformatics (ICBEB 2022), pages 1153-1163

ISBN: 978-989-758-595-1

1153

Foundation for Medical Education and Research,

2021)

. Although the essential etiology about a single

trigger causing HTN still remains to be unclear, a

lack of strong blood circulation, weakening of blood

vessel contraction, and an excessive force damaging

the internal structures of the blood vascular system

could all be the calmative causes for HTN

accompanied by external conditions especially

related to old age or bad physical circumstances (diet,

environment, etc.) (

Mayo Foundation for Medical

Education and Research, 2021)

Drugs such as Atenolol and Canderstan Cilexetil

acting as essential blockers had been commonly used

to treat HTN throughout the history of modern

medicine due to their dominance in the market.

Atenolol, a Beta-1 cardio-selective adreno-receptor

blocker (

Mayo Foundation for Medical Education

and Research, 2021)

, was originally developed by

the Imperial Chemical Industries (ICI) in 1976 and

has been approved by the public in 1981 in America

due to its effectiveness and safety as an anti-

hypertensive drug in its previous clinical trials

(

https://en.citizendium.org/wiki/National_Library

_of_Medicine.)

. Canderstan Cilexetil, an

angiotensin-receptor blocking agent treating HTN,

registered by its brand name as Atacand in the public,

was developed by the corporation Takeda in the

Medical field on the other hand with a more different

mechanism than Atenolol on a pharmaceutical scale

(

Candesartan Cilexetil)

. Overall, these two drugs

had all demonstrated their efficiency in treating

HTN.

In this literature review, these two most dominant

drugs in the medical market, atenolol and canderstan

cilexetil, will be cross-examined based on their

chemical properties, mechanism of action, and

modes of delivery from both a therapeutical and

economic standpoint in order to search for the most

optimal solution on the treatment of hypertension.

DESCRIPTION OF CHEMICAL

STRUCTURES OF DRUGS

2.1 Atenolol (Generic Name)

Atenolol, commonly recognized by its brand name as

Tenoretic or Tenormin

(

https://pubchem.ncbi.nlm.nih.gov/compound/ate

nolol)

, has a molar mass of 266.336 g·mol−1 and is

solid in the form as white crystalline powder under

room temperature (

Libretexts, 2020);

(https://www.chem960.com/cas/29122687/)

. As

shown in Figure 1, Atenolol has a chemical

composition of C14H22N2O3

(

https://pubchem.ncbi.nlm.nih.gov/#query=C14H

22N2O3)

, and its IUPAC name is 2-(4-{2-hydroxy-

3-[(propan-2-yl) amino] propoxy} phenyl)

acetamide

(

https://pubchem.ncbi.nlm.nih.gov/compound/An

giotensin-II#section=Biologic-Description)

. On

the behalf of its chemical properties, Atenolol has an

approximate melting point ranging from 146-148°C

along with a pka value of 9.6 in its internal structure

(

https://go.drugbank.com/drugs/DB00335);

(Karaman, 2016)

. As a chemical substance that is

highly soluble in liquid including methanol and

hydrochloric acid, Atenolol also possesses a

solubility of 13300 mg/L at the temperature of 25°C

(

https://pubchem.ncbi.nlm.nih.gov/compound/ate

nolol#section=Solubility)

Figure 1: Chemical structure of Atenolol.

2.2 Canderstan Cilexetil (Generic

Name)

Canderstan Cilexetil, registered as Atacand as its

public brand name, has a common molar mass of

440.463 g·mol−1 in normal state

(

https://pubchem.ncbi.nlm.nih.gov/compound/Ca

ndesartan-cilexetil)

. As shown in Figure 2,

Canderstan Cilexetil has a chemical structure written

as C33H34N6O6 and was named in the form of

IUPAC nomenclature as 1-{[(cyclohexyloxy)

carbonyl]oxy}ethyl2-ethoxy-1-{[2'-(1H-1,2,3,4-

tetrazol-5-yl)-[1,1'-biphenyl]-4-yl]methyl}-1H-1,3-

benzodiazole-7-carboxylate (

Candesartan Cilexetil,

2021)

. Canderstan also has a strong acidic pka value

of 4.23 and a strong basic pka value of 1.45

(

https://chemaxon.com/products/calculators-and-

predictors#pka.

), along with a water solubility value

ICBEB 2022 - The International Conference on Biomedical Engineering and Bioinformatics

1154

at 0.00204mg/ml under normal condition

(

http://www.vcclab.org/lab/alogps/);

(https://pubmed.ncbi.nlm.nih.gov/11749573/.)

Canderstan Cilexetil has a single chiral center at its

cyclohexyloxycarbonyloxy ethyl ester group,

indicating its specific characteristics as a chemical

compound acting as an angiotensin-receptor

blocking agent (

Pharmaceuticals, A. N. I., 2020)

Functions of its chemical structure on the behalf of

treating hypertension will be discussed furthermore

in the next section.

Figure 2: Chemical structure of Canderstan Cilexetil.

DISCUSSION OF DRUG

PHARMACOLOGY

3.1 Drug Targets Description and

Characteristics

(1) β-1 Adrenergic receptor & its corresponding

hormones

The Beta-1 receptor is a specific adrenergic

receptor primarily found within the body’s heart and

kidney cells (

CV;, A. S. P. (n.d.)

. As a receptor

responsible for the transportation of signals within

the sympathetic nervous system, the Beta-1

adrenergic receptor majorly passes signals through

the Gs alpha subunit that triggers the initiation of a

cAMP-dependent pathway and eventually amplifies

the Beta-1 receptor’s functions within the body

(

CV;, A. S. P. (n.d.)

. With the activation of beta-1

receptors through the cAMP-dependent pathway, the

beta-1 receptors inside the heart can thus perform

their tasks as receptors responsible of increasing the

contractions within the ventricular muscle, sinoatrial

node, and the atrioventricular node that amplify heart

rate and blood pressure in combination (

CV;, A. S.

P. (n.d.); (Steinberg SF)

. Based on its characteristics

to make use of the Gs alpha subunit as passageway,

the structure of Beta-1 receptor is specifically

classified as G protein-coupled receptor (GPCRs)

that has seven transmembrane regions with two

different terminal (N-terminus & C-terminus)

located both on the outside and inside of the cell

(

M.T., P. (n.d.)

Figure 3: Structure of the β-1 adrenergic receptor (

https://www.esrf.fr/news/spotlight/spotlight145/index_html).

Description of Figure:

Figure 4 has demonstrated the typical structure of

the Beta-1 receptor (as GPCR) located in heart cells

with labels of its structure: (extracellular N-terminus

& intracellular C-terminus). These receptors often

have the characteristics to be extremely dynamic and

easily conformational between its active state and

inactive state. These characteristics all eventually

Cross Examination of Atenolol and Canderstan Cilexetil on the Treatment of Hypertension

1155

contributes to Beta-1 receptor’s extreme instability

on the performance of its job as a blood pressure

regulator and can easily be disruptive and has high

potential to trigger HTN

(

https://www.esrf.fr/news/spotlight/spotlight145/i

ndex_html.)

. (End of figure description)

A variety of hormones including dopamine,

epinephrine, and norepinephrine can bind to the

Beta-1 receptors within the heart, kidney, and

sympathetic nervous system. While dopamine and

norepinephrine have the affinity to target both Beta-

1 and Beta-2 receptor almost equally, the hormone

epinephrine has demonstrated the strongest affinity

toward the binding to Beta-1 receptor, making it the

most effective hormone in the Beta-1 pathway to

affect blood pressure and muscle contraction

amongst all the other hormones triggering the

activation of beta-1 receptor (

Lennarz, 2013)

(2) Angiotensin II (Ang II) & Type 1 (AT1)

Angiotensin II receptor

Angiotensin II (Ang II) is an organic peptide

hormone derived from Angiotensin I in the renin-

angiotensin system (RAAS) that can raise blood

pressure through causing contraction within blood

vessels and increasing sodium concentration within

the kidney (

I;, F. F. M. K. T. (n.d.)

. Thus, once too

much Ang II has accumulated within human organs

or in the RAAS system, it could potentially lead to

serious problems that would trigger HTN. Inside the

cardiovascular vessels, Ang II acts as one of the main

factors having a significant effect in the renin-

angiotensin system that regulates the cardiovascular

metabolism and homeostasis through the pathway of

its type 1 (AT1) and type 2 (AT2) receptors (

I;, F. F.

M. K. T. (n.d.)

The human AT1 Ang II receptor is specifically

encoded between the 29

to 10

position within the

protein sequence P30556, which has the conserved

feature of TM helix 1 that is classified to have a

seven-transmembrane helix domain

(

https://www.ncbi.nlm.nih.gov/Structure/cdd/cd1

5192.); (CDD Conserved Protein Domain Family:

7tmA_AT1R (nih.gov) (database)

). Based on this

domain’s specific function, the AT1 receptor

therefore can perform blood cell proliferation easily

due to its highly transmembrane feature (to pass

essential particles across cellular membrane) which

eventually contributes to the increase in blood

pressure with the multiplication of blood cells

(CDD

Conserved Protein Domain Family: 7tmA_AT1R

(nih.gov) (database)

. Thus, the activation of the

AT1 receptor domain through Ang II has become one

of the most evident features contributing to HTN on

a molecular scale.

Figure 4 Protein Sequences of AT1 Ang II receptor in various animals

(CDD Conserved Protein Domain Family:

7tmA_AT1R (nih.gov) (database).

Description of Figure:

Figure 5 has demonstrated a variety of protein

sequences encoding the AT1 receptor in RAAS

system responsible of receiving Ang II peptide

(CDD Conserved Protein Domain Family:

7tmA_AT1R (nih.gov) (database)

. The query

sequence P30556 represents for the protein sequence

in human that coded for the specific structure of AT1

receptor, while the highlighted yellow regions in all

these sequences represent the feature TM helix 1 in

the AT1 receptor coding sequence

(CDD Conserved

Protein Domain Family: 7tmA_AT1R (nih.gov)

(database)

. (End of figure description)

Figure 5 Chemical structure of Angiotensin II

(CDD Conserved Protein Domain Family: 7tmA_AT1R (nih.gov)

(database).

ICBEB 2022 - The International Conference on Biomedical Engineering and Bioinformatics

1156

3.2 Drug Effect on Targets Description

(1) Atenolol on β-1 Adrenergic receptor

Atenolol, a beta-1 selective agent, has been

widely used as an antihypertensive drug that

specifically targets the Beta-1 receptor to lower

blood pressure through competing with other

hormones for the binding site (extracellular N-

terminus) on the receptor (

Hasanah, Dwi Utari,

Pratiwi, 2019)

. Through connecting its methyl group

onto the extracellular N-terminus of the beta-1

receptors located in the myocardial regions, atenolol

thus inhibits their action to increase blood pressure

and cardio muscular contraction through producing

inotropic and negative chronotropic activities

(

Hasanah, Dwi Utari, Pratiwi, 2019);

(https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6

526#section=Mechanism-of-Action-(Complete))

The negative chronotropic activities initiated by

atenolol within heart tissues such as the sinoatrial

node would eventually decrease the rate of electrical

signal discharges from the sinoatrial node and

gradually lowers heart rate by approximately 25-35%

(https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6

526#section=Mechanism-of-Action-(Complete))

Atenolol would also reduce the regular cardiac

output by about 20% through its binding with the

Beta-1 receptor on a secondary position in

comparison to the decrease of heart rate and

myocardial muscular contraction

(https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6

526#section=Mechanism-of-Action-(Complete))

Although atenolol trigger could possibly influence

the increase in oxygen requirements through

stimulating left ventricular fiber length to amplify

end-diastolic pressure especially in patients

diagnosed with cardiac failure, it generally would

reduce oxygen consumption through decreasing

myocardial contraction and eventually lead to pain-

relief of muscles in the myocardial region

particularly effective for patients diagnosed with

HTN-related angina pectoris

(https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6

526#section=Mechanism-of-Action-(Complete))

A high dosage of the atenolol drug might possibly

lead to sinus arrest within patients in a life-

threatening stage. Moreover, atenolol could also lead

to increase in patient’s stroke index by about 10% as

one of its side-effects

(https://pubchem.ncbi.nlm.nih.gov/source/hsdb/6

526#section=Mechanism-of-Action-(Complete))

Figure 6: Mechanism of Beta-adrenergic blocking drug (atenolol) binding to receptor site (

http://dxline.info/diseases/beta-

blocker).

Description of Figure:

Figure 7 has demonstrated a simple illustration

for the process of atenolol competition with other

naturally occurring hormones for the binding site of

Beta-1 receptor on myocardial tissue cells. The

atenolol chemicals would reach the receptor site on

cell surface before hormones such as epinephrine or

norepinephrine in the sympathetic nervous system to

alter the receptor’s function with a high affinity

(

http://dxline.info/diseases/beta-blocker.)

. (End of

figure description)

(2) Canderstan Cilexetil on Type 1 (AT1)

Angiotensin II receptor

Canderstan Cilexetil has been commonly used as

an angiotensin-receptor blocker (ARB) medicine for

treating hypertension and many of its related

complications. Canderstan cilexetil, once rapidly

converted into its complete form as Canderstan

Cross Examination of Atenolol and Canderstan Cilexetil on the Treatment of Hypertension

1157

inside the body (see next section for further

details/reasons), will actively seek for AT1 Ang II

receptors and attaches itself onto the target. Once

Canderstan is attached to AT1 receptors, it will

restrain Ang II to connect to these receptors and thus

stops Ang II stimulating the AT1 receptors to

produce aldosterone that could lead to

vasoconstriction through reabsorbing water and

sodium which could eventually lead to HTN if the

pressure exerted by this action (vasoconstriction) is

too high

(

https://go.drugbank.com/drugs/DB11842)

In the whole process, as shown in Figure 8,

Canderstan cilexetil acts as an antagonist toward the

renin-angiotensin-aldosterone (RAAS) system that

would selectively competes for binding site with Ang

II and blocks the aldosterone secreting effects and

vasoconstrictor of Ang II in many parts of the human

body including the adrenal gland and vascular

smooth muscle (

Giacchetti G; Opocher G; Sarzani

R; Rappelli A; Mantero F; (n.d.))

. On a closer look,

the adrenal gland discussed in this process would

directly trigger the production of epinephrine within

itself that could furthermore initiates the binding

process to the beta-1 adrenergic receptor and raises

blood pressure if nothing acts to stop the reaction

(

Adrenal glands. Johns Hopkins Medicine. (n.d.))

Thus, Canderstan cilexetil’s blockade onto the Ang

II receptor would actually not only help stopping

blood pressure to be raised through processes within

the RAAS system, but it would also help to stop

epinephrine from binding onto the beta-1 receptor in

advance since once AT1 receptors in the adrenal

gland are inactivated, the adrenal gland would also

stop to produce the corresponding chemicals

required in the body. This process furthermore

proves this drug’s high efficiency in stopping HTN

since canderstan could has an effect in both systems

discussed (beta-1 adrenergic & Angiotensin II

receptor) in this specific paper.

Figure 7: Mechanism of angiotensin receptor blocking drug (canderstan) binding to receptor (

Aquarius, 2013).

3.3 Modes of Delivery and Related

Characteristics

(1) Atenolol

The most traditional way of absorbing atenolol

for treating hypertension is most directly related to

oral delivery. It is suggested that for an average adult

diagnosed with hypertension, atenolol should be

taken on an average day with 50-100mg three times

per day for a month’s period (

Choudhary, 2016)

Although constantly delivered to patients orally,

the bioavailability of absorbing atenolol through this

mode of delivery has actually been proven to be very

low with only an index of 50% which directly infers

that it would take almost 2 weeks for atenolol to

actually make an effect within the human body after

ICBEB 2022 - The International Conference on Biomedical Engineering and Bioinformatics

1158

taking it orally. Recently, studies had shown that the

process of transdermal delivery could actually be a

potential alternative to oral absorption since many

clinical studies has all demonstrated that transdermal

delivery of atenolol could actually increase the

therapeutic efficacy for atenolol to be dissolved in

the body. Since atenolol has a relatively high pka

value of 9.6 under normal circumstances, the

dissolution of atenolol within body through

transdermal iontophoresis could possibly be a better

solution than delivering atenolol to patients through

the mouth. Essentially, iontophoresis could reduce

the lag time of medical effect to happen, increase rate

of transportation of atenolol within the body, and

allow better control over the delivery of drugs

(

Ramkanth, 2018); (SM;, M.-D. S. N.-J. M. R. G.

(n.d.)

Figure 8: Illustration of Transdermal Iontophoresis (

Team, H. J., & Team, H. J. (2018).

Description of Figure:

Figure 9 has demonstrated a typical illustration

of the mechanism for iontophoresis on the skin

surface. On the surface, a simple battery powered

direct current (DC) has been connected with both the

anode (+ charge) and cathode (- charge) to transport

drug chemicals or macromolecules through the three

layers of the skin into the blood vessels and inner part

of the body through facilitating ions both charged

positively and negatively in the electrical current.

The transportation pathway of the drug particles

directly forms a loophole with the electrical power

supply in this way, giving drugs a faster rate to be

transported with electrical charges (

Team, H. J., &

Team, H. J. (2018)

. (End of figure description)

(2) Canderstan Cilexetil

Before absorbed by patients, canderstan cilexetil

is only a biological inactive compound (prodrug) that

still requires to be converted into its complete form

in order to make an impact to the targeted receptors

within the body. Once orally delivered, canderstan

cilexetil will directly enters the gastrointestinal tract

and become bioactivated through ester hydrolysis,

which will eventually convert canderstan cilexetil

into canderstan---the full selective AT1 receptor

antagonist/blocker. It is said that canderstan could

only be poorly absorbed after delivered to the patient

orally in its complete form, thus the ester prodrug

form of canderstan cilexetil must be prepared in

order to exert the maximum effect to the body as an

organic drug. After canderstan performs its function

inside the body, the drug chemical will mainly be

excreted unchanged outside the body via urine and

feces. The drug chemical would undergo minor

hepatic metabolism into the inactivate metabolite and

thus transport outside body in an approximate time

of 9 hours (roughly the half-life for canderstan). It is

suggested that canderstan cilexetil should be taken

orally per time for a monthly prescription time with

up to a 32 mg since 64% of the canderstan cilexetil

would be excreted outside the body during

absorption the form of feces, so a relatively large

amount of the prodrug is required to be taken in

(

Khawaja, 2011)

Cross Examination of Atenolol and Canderstan Cilexetil on the Treatment of Hypertension

1159

4 DISCUSSION OF DRUG

ECONOMICS

4.1 Atenolol

Atenolol was commonly sold in the current medical

market as both an antihypertensive, diuretic, and

anti-angina pectoris drug for customers (

Atenolol /

CHLORTHALIDONE Prices, coupons & savings

tips. GoodRx. (n.d.))

. In the market, Atenolol was

sold by many different pharmaceutical companies

ranging from the cheapest with a price of only $14.83

per prescription for a course of treatment sold by

GoodRx to an average retail price of $33.50 in each

distinct market dominated by different price

elasticity of demand value for medical products

(

Atenolol / CHLORTHALIDONE Prices,

coupons & savings tips. GoodRx. (n.d.))

. The price

elasticity of demand (PED) is a specific economic

index measuring the sensitivity of customer’s

willingness to purchase a specific product in respond

to the change of market price for that product, and in

the case of medical markets related to atenolol as an

inexpensive prescription drug, the PED value is

constantly changing in relationship to the amount of

atenolol products throughout the world, making the

price of atenolol hard to be standardized due to the

constant change in both the economic index and the

different private companies responsible for the

production of atenolol drug (

Price elasticity of

demand - harvard university. (n.d.))

4.2 Canderstan Cilexetil

Canderstan Cilexetil was often sold in the public

medical market with a relatively higher price in

comparison with atenolol. The standard GoodRx

price for canderstan cilexetil is around $23.54 per

prescription, and the average retail price for

canderstan cilexetil in the modern market is $90.79,

which is around 74% higher than the GoodRx

standard price. The high price for canderstan cilexetil

thus made it an infamous drug in the hypertension

market as most patient diagnosed with HTN often

lived in a low- and middle-income society where

they cannot afford so much money to purchase an

almost luxurious drug for the normal prescription

treatment (Candesartan prices, coupons & savings

tips. GoodRx. (n.d.).). However, a high price and low

purchase rate does not mean that canderstan cilexetil

has a poor quality over treating HTN. In comparison,

canderstan cilexetil do have a better effect over the

treatment of HTN than atenolol----their comparison

will be discussed furthermore in the next section.

5 DISCUSSION AND

CONCLUSION

From a therapeutical perspective, canderstan cilexetil

has demonstrated a higher efficiency in treating

hypertension than atenolol since it could bind to

receptors located in many different parts of the body

organs including the adrenal gland and smooth

cardiovascular muscle to cease hypertension through

both binding sites, while atenolol could only work to

stop the increase in blood pressure if it is bond to the

correct receptors inside the cardiovascular tissue

through the adrenergic pathway. These two drugs

are, essentially, very similar in their function

mechanism since they both acts as essential blockers

for receptors in order to stop high blood pressure, but

they still are working in two different systems as

atenolol makes its impact. Whereas atenolol

functions in the adrenergic system, canderstan works

in the renin-angiotensin system to stop both

aldosterone and the production of epinephrine to

cease hypertension which also marks one merit of

canderstan cilexetil on the treatment of hypertension

since it could eventually block the production of two

high blood pressure-triggering chemicals, while

atenolol could only stop the production of one

chemical channel in the angiotensin system.

From an economic standpoint, atenolol does

looks to have a better foreground than canderstan.

Whereas Atenolol has a cheaper price (lowest:

$14.83) than canderstan cilexetil (lowest: $23.54), it

also has a wider consumer population throughout the

globe because of its easy-accessibility and wide

production recognized by many medical private

companies. As mentioned previously in this

literature review, hypertensions most commonly

occur in low- and middle-income countries, so many

hypertensions diagnosed patients would actually be

more apt to choose a more inexpensive medicine for

treatment because many of them could not afford to

use such a costly medicine like canderstan cilexetil

to treat their diagnosed condition. Thus, in

conclusion, atenolol and canderstan all have

demonstrated their merits distinctively in the

perspective of pharmacology or in the field of

economy on the behalf of considering for the

treatment of hypertension.

ICBEB 2022 - The International Conference on Biomedical Engineering and Bioinformatics

1160

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