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Imidapril is an oral angiotensin-converting enzyme (ACE) inhibitor used primarily for the treatment of essential hypertension and chronic heart failure. It is a prodrug that is converted in the liver to its active metabolite, imidaprilat. Imidaprilat competitively inhibits ACE, blocking the conversion of angiotensin I to angiotensin II—a potent vasoconstrictor—thereby reducing arterial vasoconstriction, blood pressure, and aldosterone secretion. This leads to vasodilation and increased sodium excretion with water outflow. Imidapril may also improve insulin sensitivity by enhancing insulin signaling pathways. The drug has been investigated for other indications such as autosomal dominant polycystic kidney disease and diabetic nephropathy associated with type 1 diabetes mellitus[1][2][3][4][6][7][8].
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