Clinical observations and epidemiological surveys indicated that the prevalence of hypertension and heart diseases is increased in cold regions or during winter. Cold exposure increased NADPH oxidase gp91 phox protein expression in heart, kidneys, and aorta in rats. The aim of this study was to investigate if RNA interference (RNAi) silencing of gp91 phox would attenuate cold-induced hypertension and cardiovascular and renal damage. The recombinant adeno-associated virus serotype 2 (AAV-2) vector carrying gp91 phox -shRNA (gp91-shRNA) was constructed for inhibiting gp91 phox protein expression in cold-exposed rats. Blood pressure (BP) was monitored using a telemetry system. BP was increased in the Control-shRNA and PBS groups within 1 week of exposure to moderate cold (5°C) and reached a plateau after 7 weeks. The cold-induced increase in BP was attenuated significantly by intravenous delivery of gp91-shRNA (1.25 · 10 10 particles/rat, 0.5 mL). One single dose of gp91-shRNA controlled hypertension for up to 10 weeks. In addition, gp91-shRNA reversed coldinduced vascular dysfunction. gp91-shRNA abolished the cold-induced up-regulation of gp91 phox protein expression in heart, kidneys, and aorta, confirming effective silencing of gp91phox . The cold-induced increases in NADPH oxidase activity and superoxide production were eliminated by silencing of gp91 phox , suggesting that the cold-induced up-regulation of NADPH oxidase activity may be attributed to the increased gp91 phox protein expression. RNAi silencing of gp91 phox abolished cold-induced cardiac and renal hypertrophy and attenuated aortic, coronary, and renal remodeling. The up-regulation of gp91 phox may play a critical role in cold-induced cardiovascular dysfunction and organ damage. AAV delivery of gp91-shRNA may be a new and effective therapeutic approach for cold-related cardiovascular disorders.