The angiotensin II type 1 (AT 1 ) receptor is the primary effector for angiotensin II (Ang II), a key peptide regulator of blood pressure and fluid homeostasis. AT 1 receptors are involved in the pathogenesis of several cardiovascular diseases, including hypertension, cardiac hypertrophy, and congestive heart failure, which are characterized by significant interindividual variation in disease risk, progression, and response to pharmacotherapy. Such variation could arise from genomic polymorphisms in the AT 1 receptor. To pursue this notion, we have pharmacologically characterized seven known and putative nonsynonymous AT 1 receptor variants. Functional analysis using the cell-based assay receptor selection and amplification technology (R-SAT) revealed that three variants (AT 1 -G45R, AT 1 -F204S, and AT 1 -C289W) displayed altered responses to Ang II and other AT 1 receptor agonists and antagonists. Agonist responses to Ang II were absent for AT 1 -G45R and significantly reduced in potency for AT 1 -C289W (11-fold) and AT 1 -F204S (57-fold) compared with the wild-type (WT) receptor. AT 1 -F204S also displayed reduced relative efficacy (57%). Quantitatively similar results were obtained in two additional functional assays, phosphatidyl inositol hydrolysis and extracellular signal-regulated kinase activation. Radioligand binding studies revealed that AT 1 -G45R failed to bind Ang II, whereas cell surface staining clearly showed that it trafficked to the cell surface. AT 1 -C289W and AT 1 -F204S displayed reduced binding affinities of 3-and 5-fold and reduced cell surface expression of 43 and 60% of that observed for the WT receptor, respectively. These data demonstrate that polymorphic variation in the human AT 1 receptor induces loss of functional phenotypes, which may constitute the molecular basis of variability of AT 1 receptor-mediated physiological responses.Angiotensin II type 1 (AT 1 ) receptors (Takayanagi et al., 1992) mediate many of the physiological effects of angiotensin II (Ang II), an endogenous octapeptide that, via the actions of the renin-angiotensin system, serves as one of the pivotal regulators of blood pressure and fluid homeostasis. The AT 1 receptor is a highly conserved seven-transmembrane (7TM) receptor expressed in most tissues, particularly in vascular and renal tissues, where receptor activation leads to vasoconstriction and water retention. The renin-angiotensin system subserves critical pathophysiological roles in several cardiovascular diseases, including hypertension, cardiac hypertrophy, congestive heart failure, diabetic nephropathy,