Abstract-Chronic increases in blood flow increase arterial diameter and NO-dependent dilation in resistance arteries.Because endothelial dysfunction accompanies metabolic syndrome, we hypothesized that flow-mediated remodeling might be impaired in obese rat resistance arteries. Obese and lean Zucker rat mesenteric resistance arteries were exposed to chronic flow increases through arterial ligation in vivo: arteries exposed to high flow were compared with normal flow arteries. Diameter was measured in vitro in cannulated arteries using pressure arteriography. After 7 days, outward remodeling (diameter increased from 346Ϯ9 to 412Ϯ11 m at 100 mm Hg) occurred in lean high-flow arteries. Endothelium-dependent tone was reduced in high-flow arteries from obese rats by contrast with lean animals. On the other hand, diameter enlargement occurred similarly in the 2 strains. The involvement of NO in endothelium-dependent dilation (evidenced by NO blockade) and endothelial NO synthase phosphorylation was smaller in obese than in lean rats. Superoxide anion and reduced nicotinamide-adenine dinucleotide phosphate oxidase subunit expression (p67phox and gp91phox) increased in obese rats and were higher in high-flow than in control arteries. Acute Tempol (a catalase mimetic), catalase plus superoxide dismutase, and L-arginine plus tetrahydrobiopterin restored endothelium-dependent dilation in obese rat normal and high-flow arteries to the level found in lean control arteries. Thus, flow-induced remodeling in obese resistance arteries was associated with a reduced endothelium-mediated dilation because of a decreased NO bioavailability and an excessive superoxide production. This dysfunction might have negative consequences in ischemic diseases in patients with obesity or metabolic syndrome. Key Words: resistance arteries Ⅲ shear stress Ⅲ NO Ⅲ reactive oxygen species Ⅲ mechanotransduction Ⅲ obesity Ⅲ metabolic syndrome T he metabolic syndrome is a common health problem. Its incidence and prevalence are increasing in parallel with the enhanced prevalence and incidence of obesity and type 2 diabetes. 1,2 This syndrome is not only a metabolic disorder; it is also associated with endothelial dysfunction 3 and vascular remodeling leading to a reduction in arterial diameter. 4 Patients with metabolic syndrome demonstrate an increasing risk of overall mortality, as well as cardiovascular morbidity and mortality. 5 Basically, an increase in blood pressure or a decrease in blood flow induces a transient adjustment in vessel diameter mediated by changes in myogenic tone and by the release of vasoactive substances. On the other hand, increasing blood flow induces a vasodilation mediated by endothelium-derived NO. A long-term exposition to altered mechanical forces induces vascular remodeling to restore tensile and shear stresses. 6,7 Long-term increase in shear stress enhances NO production by endothelial cells, and we have shown previously that NO has a key role in vascular remodeling of large 8 and resistance arteries in response to an in...