Abstract-The rostral ventrolateral medulla (RVLM) is a relay point that provides supraspinal excitatory input to sympathetic preganglionic neurons in the regulation of blood pressure. The importance of the RVLM is further highlighted by observations that an increase of RVLM sensitivity to angiotensin II and enhanced sympathetic activity are associated with hypertension. Angiotensin-converting enzyme 2 (ACE2) has been shown to be central in maintaining the balance between vasoconstrictor activity of angiotensin II with vasoprotective action of angiotensin-(1-7) in the peripheral system. However, its role in central control of blood pressure in the RVLM is yet to be investigated. Thus, our objective in this study was to compare ACE2 expression in the RVLM of Wistar-Kyoto rats and spontaneously hypertensive rats and to determine whether RVLM ACE2 is involved in blood pressure control. ACE2 immunoreactivity was diffusely distributed in many cardiovascular regulatory neurons, including the RVLM. Western blot analysis revealed a 40% decrease in ACE2 in the RVLM of spontaneously hypertensive rat compared with Wistar-Kyoto rats. Lentiviral-mediated overexpression of ACE2 (lenti-ACE2) was used to determine whether a decrease in ACE2 in the RVLM is associated with hypertensive state. Bilateral injection of lenti-ACE2 resulted in a long-term expression of transgenic ACE2. This was associated with a decrease in mean arterial pressure exclusively in the spontaneously hypertensive rat (141Ϯ4 mm Hg in lenti-GFP versus 124Ϯ5 mm Hg in lenti-ACE2) and heart rate (304Ϯ7 bpm in lenti-GFP versus 285Ϯ5 bpm in lenti-ACE2). These observations demonstrate that overexpression of ACE2 overcomes its intrinsic decrease in the RVLM and decreases high blood pressure in the spontaneously hypertensive rat. ncreasing evidence indicates that a hyperactive brain renin-angiotensin system (RAS) is critical in the development and maintenance of hypertension. The rostral ventrolateral medulla (RVLM) is 1 of the brain areas that coordinate the propagation of angiotensin (Ang) II signals leading to hyperactivity of this hormone in hypertension. 1 This conclusion is supported by observations that the RVLM is considered the final relay point before transmission of Ang II signals to periphery 2 and that Ang II type 1 receptors and Ang II sensitivity in the RVLM of spontaneously hypertensive rats (SHRs) and other rat models of hypertension are increased. [3][4][5] Thus, regulation of the RAS activity in the RVLM is critical in a long-term regulation of neural control of blood pressure and other cardiovascular functions.The recent discovery of angiotensin-converting enzyme 2 (ACE2) provides a novel target for a chronic regulation of the brain Ang II system with implications on a long-term beneficial outcome to the cardiovascular system. 6,7 ACE2 has been implicated in maintaining the balance between vasoconstrictor activity of Ang II with vasoprotective actions of Ang-(1-7) and other related peptides in the peripheral system. 8 -10 As a result, it has been ...