Comparison of the Incidence of Imidapril and Enalapril Induced Cough
Warangkna Boonyapisit MD*, Damras Tresukosol MD*
Affiliation : *Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Background : Imidapril is an angiotensin converting enzyme (ACE) inhibitor without a sulfhydril group
which has been shown from previous study to have low incidence of ACE inhibitor induced cough.
Objective : To compare the incidence of cough between two ACE inhibitors, imidapril and enalapril
Material and Method: A comparative cross over study was performed in 119 patients with hypertension or left
ventricular dysfunction. Patients were assigned to one of the two treatment groups, either a group receiving
imidapril or enalapril for 4 weeks (Period I) and then these same groups were crossed over to receive either
enalapril or imidapril for 4 weeks (Period II). The occurrence of cough during treatment was monitored by
interviewing the patients.
Results : The incidence of cough was 44 % while on imidapril treatment and 66% while on enalapril treatment
(p = 0.0014). The antihypertensive effects of two drugs were not different.
Conclusion : The incidence of cough was significantly less under imidapril than under enalapril treatment,
while there was no difference in the antihypertensive effects between the two ACE inhibitors.
Keywords : Angiotensin converting enzyme inhibitors, Angiotensin converting enzyme inhibitors induced cough
