Abstract-This study tested whether the melanocortin 4-receptor (MC4R) is essential for the chronic cardiovascular and metabolic actions of leptin. Twenty-to 22-week-old male wild-type (WT) C57BL/6J and obese MC4R (Ϫ/Ϫ) mice (Nϭ5 to 6 per group) were implanted with radiotelemetric transmitters and catheters for measuring mean arterial pressure (MAP) and heart rate 24 hours per day and intravenous infusions. After a 3-day stable control period, leptin was infused (2 g/kg per minute IV) for 7 days in WT, obese ad libitum-fed MC4R (Ϫ/Ϫ), and nonobese pair-fed MC4R (Ϫ/Ϫ) mice. WT mice receiving vehicle for 7 days served as controls. MC4 (Ϫ/Ϫ) mice were 30% heavier and had 4-and 11-fold increases in plasma insulin and leptin levels, respectively, compared with WT mice. Despite obesity, MAP and heart rate tended to be lower in MC4R (Ϫ/Ϫ) mice compared with WT mice. Chronic leptin infusion in the different groups increased plasma leptin levels to 45 to 65 ng/mL. Seven-day leptin infusion in WT mice increased MAP by 12Ϯ3 mm Hg despite a 35% reduction in food intake and an 8% reduction in body weight. Leptin did not alter plasma glucose but reduced plasma insulin in WT mice (5.9Ϯ1.0 versus 3.0Ϯ0.5 U/mL). These cardiovascular and metabolic actions of leptin were abolished in obese and nonobese MC4R (Ϫ/Ϫ) mice. These data suggest that MC4R deficiency, and not obesity-induced leptin resistance, abolished the cardiovascular and metabolic actions of leptin in obese MC4R (Ϫ/Ϫ) mice. Thus, a functional MC4R is essential for the chronic cardiovascular and metabolic actions of leptin. (Hypertension. 2006;48:58-64.)Key Words: hypertension Ⅲ arterial pressure Ⅲ heart rate Ⅲ insulin Ⅲ insulin resistance Ⅲ obesity Ⅲ hypothalamus Ⅲ sympathetic nervous system L eptin, a 167-amino-acid peptide released from adipocytes, acts on the central nervous system (CNS) to suppress appetite and increase energy expenditure by increasing sympathetic nervous system (SNS) activity to thermogenic tissues, such as the brown adipose tissue. 1,2 Leptin also increases sympathetic activity to nonthermogenic organs, such as the kidneys and adrenal glands. 2 Moreover, chronic leptin infusion in rats increases arterial pressure, and this effect can be inhibited by combined ␣-and -adrenergic receptor blockade, suggesting a role for the SNS in the pressor actions of leptin. 3 Neuroanatomical and functional studies indicate an important role for the hypothalamic pro-opiomelanocortin (POMC) neurons in mediating some of the actions of leptin. POMC neurons are principal sites of leptin receptor expression, and leptin increases POMC neuronal firing and POMC protein expression. 4,5 Conditional POMC neuron-specific leptin receptor deletion in mice leads to a modest increase in body weight. 6 One of the byproducts of hypothalamic POMC post-translational processing, ␣-melanocyte-stimulating hormone (␣-MSH), is considered to be an important mediator of some of the action of leptin to reduce food intake. ␣-MSH binds the hypothalamic melanocortin 3/4 receptors (MC3/4R) to e...