Angiotensin II (Ang II) is a potent stimulator of plasminogen activator inhibitor-1 (PAI-1) expression, which is an important regulator of pathogenesis of atherosclerosis. Rho-kinase, a downstream target protein of small GTP-binding protein Rho, plays a key role for various cellular functions. We evaluated the cardioprotective effects of a specific Rho-kinase inhibitor, (R)-(ϩ)-trans-N-(4-pyridyl)-4-(1-aminoethyl)-cyclohexanecarboxamide (Y-27632), and an Ang II type 1 receptor antagonist, candesartan, on PAI-1 gene expression and cardiovascular remodeling in Ang II-induced hypertensive rats. Rats given Ang II alone (200 ng ⅐ kg Ϫ1 ⅐ min Ϫ1 ) were compared with rats also receiving Ang II plus Y-27632 or Ang II plus candesartan. Ang II-induced PAI-1 mRNA up-regulation in the left ventricle was inhibited by Y-27632 and candesartan. In addition, increased RhoA protein, Rho-kinase, and c-fos gene expression, and myosin light chain phosphorylation were suppressed by Y-27632 and candesartan. In contrast, Y-27632 had no effect on Ang II-stimulated phospho-p42/p44 extracellular signalregulated kinases (ERK) and phospho-p70S6 kinase activities, which are reported to be involved in Ang II-induced protein synthesis. Moreover, activated Ang II-induced phosphorylation of ERK and p70S6 kinase were blocked by candesartan. Y-27632 or candesartan administration resulted in significant improvements in the wall-to-lumen ratio, perivascular fibrosis, and myocardial fibrosis. These results suggested that differential activation of Rho-kinase and ERK pathways may play a critical role in Ang II-induce PAI-1 gene expression, and upregulation of Rho-kinase plays a key role in the pathogenesis of Ang II-induced hypertensive rats. Thus, inhibition of the Rhokinase pathway may be at least a useful therapeutic strategy for treating cardiovascular remodeling.Left ventricular hypertrophy is the primary mechanism by which the heart compensates for a sustained increase in hemodynamic loading. Previous studies have shown that increased load itself is directly linked to hypertrophic growth in terms of both a quantitative increase in cardiac mass and qualitative changes in the cardiac phenotype (Cooper, 1987). However, the signaling mechanisms of hypertrophic cardiac growth are largely unknown. Activation of cell proliferation by hormones and growth factors has been shown to correlate with the intracellular activation of several interacting protein cascades. One of the kinases activated by all mitogens is p70S6 kinase, which leads to phosphorylation of the ribosomal S6 protein and increases the rate of translation of mRNAs containing a polypyrimidine tract. Previous studies have demonstrated P70S6 kinase activation in several cell types after either mitogenic stimulation, mechanical stretch, or integrin receptor engagement. Therefore, p70S6 kinase could play a key role in the load-induced hypertrophic growth process (Laser et al., 1998). Furthermore, the mitogen-activated protein kinases are a superfamily of proline-directed serine/threonin...