Angiotensin-converting enzyme (ACE) is responsible for the conversion of angiotensin I (ATI) to angiotensin II (ATII), which regulates blood pressure and is a key component of the renin-angiotensin-aldosterone system (RAAS) [4]. Imidapril hydrochloride (imidapril) is a long-acting, non-sulfhydryl angiotensin-converting enzyme (ACE) inhibitor, which has been used clinically in the treatment of hypertension, chronic congestive heart failure (CHF), acute myocardial infarction (AMI), and diabetic nephropathy [5]. After oral administration, imidapril is rapidly converted in the liver to its active metabolite imidaprilat. The plasma levels of imidaprilat gradually increase in proportion to the dose, and decline slowly. The time to reach the maximum plasma concentration (Tmax) is 2.0 h for imidapril and 9.3 h for imidaprilat. The elimination half-lives (t1/2) of imidapril and imidaprilat is 1.7 and 14.8 h, respectively [5]. In patients with hypertension, blood pressure was still decreased at 24 h after imidapril administration. The antihypertensive effect of imidapril was dose-dependent [5]. The maximal reduction of blood pressure and plasma ACE was achieved with imidapril, 10 mg once daily, and the additional effect was not prominent with higher doses. When administered to patients with AMI, imidapril improved left ventricular ejection fraction and reduced plasma brain natriuretic peptide (BNP) levels [5]. In patients with mild-to-moderate CHF [New York Heart Association (NYHA) functional class II–III], imidapril increased exercise time and physical working capacity and decreased plasma atrial natriuretic peptide (ANP) and BNP levels in a dose-related manner. In patients with diabetic nephropathy, imidapril decreased urinary albumin excretion [5].
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