Abstract-Endothelin (ET) exerts powerful pressor actions primarily through activation of the ET A receptor subtype. The ET B receptor (ET B R) subtype, on the other hand, is generally thought to initiate physiological actions that decrease arterial pressure. Such actions include clearing ET from the bloodstream, initiating endothelium-mediated vasodilation, and facilitating renal sodium and water excretion. The effect of long-term activation of the ET B R on arterial pressure, however, never has been directly tested. In this study we evaluated cardiovascular responses to chronic (5-day) activation of ET B R in male rats using continuous intravenous infusion of the selective agonist sarafotoxin 6c. Surprisingly, we found that sarafotoxin 6c caused a sustained increase in arterial pressure that rapidly reversed on termination of infusion. The hypertension was associated with increased renal excretion of sodium and water and decreased plasma volume. Alterations in daily sodium intake did not affect the magnitude of the hypertension. Hemodynamic studies revealed a decreased cardiac output and increased total peripheral resistance during sarafotoxin 6c infusion. Infusion of sarafotoxin 6c caused a small increase in plasma ET levels. Nevertheless, the hypertension was not affected by coadministration of a selective ET A receptor antagonist (atrasentan) but was completely prevented by treatment with a combined ET A receptor and ET B R antagonist (A186280). These experiments reveal for the first time that chronic activation of ET B R in rats causes sustained hypertension. (Hypertension. 2007;50:512-518.)Key Words: endothelin Ⅲ ET B receptor Ⅲ salt Ⅲ hemodynamics E ndothelins (ETs) have powerful effects on arterial blood pressure regulation and contribute to the genesis of human and experimental hypertension. 1 Most ET-mediated pressor actions result from stimulation of the ET A receptor (ET A R) found in vascular smooth muscle, kidney, heart, adrenal gland, and other tissues. 1 The influence of ET B receptor (ET B R) on arterial pressure (AP) regulation has been more controversial, but the bulk of evidence supports an antihypertensive function. Knockout of the ET B R gene causes salt-sensitive hypertension in rats 2 and mice, 3,4 as does chronic pharmacological blockade of ET B R in a variety of species. 5-8 One important antihypertensive mechanism associated with ET B R activation may be enhanced renal sodium and water excretion, because renal-collecting, duct-specific knockout of ET B R causes hypertension. 9 Other studies, however, do not support a critical role for renal ET B R in controlling AP. 2 ET B Rs on endothelial cells act as plasma ET clearance receptors, 10 and their absence or blockade produces increased plasma ET levels that can activate ET A R to cause hypertension. 6 In addition, ET B Rs located on endothelial cells promote vasodilation by releasing NO and prostanoids. Nevertheless, endothelial cell ET B Rs do not seem necessary for chronic AP regulation, because their selective deletion does not cause...