-Hydroxyeicosatetraenoic acid (20-HETE) is a cytochrome P-450 (Cyp)-derived arachidonic acid metabolite that has been shown to increase smooth muscle contractions and proliferation, stimulate endothelial dysfunction and activation, and promote hypertension. We examined if 20-HETE contributes to microvascular remodeling in hypertension. In Sprague-Dawley rats, administration of the 20-HETE biosynthesis inhibitor HET0016 or the ,15(Z)-dienoic acid (20-HEDE) prevented 5␣-dihydrotestosterone (DHT)-induced increases in blood pressure as well as abrogated DHT-induced increases in the media-to-lumen ratio (M/L), media thickness, and collagen IV deposition in renal interlobar arteries. Reserpine prevented blood pressure elevation in DHT-treated rats but did not affect microvascular remodeling (M/L, media thickness, and collagen deposition); under these conditions, treatment with the 20-HETE antagonist attenuated microvascular remodeling, suggesting that 20-HETE contributes to DHT-induced vascular remodeling independent of blood pressure elevation. In Cyp4a14 Ϫ/Ϫ mice, which display androgen-driven and 20-HETE-dependent hypertension, treatment with the 20-HETE antagonist abolished remodeling of renal resistance arteries measured as media thickness (24 Ϯ 1 vs. 15 Ϯ 1 m) and M/L (0.29 Ϯ 0.03 vs. 0.17 Ϯ 0.01). Moreover, in Cyp4a12 transgenic mice in which the expression of Cyp4a12-20-HETE synthase is driven by a tetracycline-sensitive promoter, treatment with doxycycline resulted in blood pressure elevation (140 Ϯ 4 vs. 92 Ϯ 5 mmHg) and a significant increase in remodeling of renal resistance arteries (media thickness: 23 Ϯ 1 vs. 16 Ϯ 1 m; M/L: 0.39 Ϯ 0.04 vs. 0.23 Ϯ 0.02); these increases were abrogated by cotreatment with 20-HEDE. This study demonstrated that 20-HETE is a key regulator of microvascular remodeling in hypertension; its effect is independent of blood pressure elevation and androgen levels. 20-hydroxyeicosatetraenoic acid; cytochrome P-450 4A; blood pressure; androgen VASCULAR REMODELING of large and small arteries contributes to the development and complications of hypertension (25). This process renders arteries stiffer and thicker, leading to detrimental effects on blood pressure regulation (14). Structural alterations of the microcirculation, of which the media-to-lumen ratio (M/L) is the most important predictor, are likely to occur in renal microvessels, as previously shown in experimental models of hypertension (7), including spontaneously hypertensive rats (SHRs), DOCA-salt rats, and one-kidney, one-clip Goldblatt hypertensive rats (12). The mechanisms that contribute to arterial remodeling in hypertension are numerous and include stimulation of growth and apoptosis and increased inflammation and fibrosis. Numerous autacoids have been implicated as mediators of arterial remodeling in hypertension. The most prominent is ANG II, which has been shown to exert the capacity of stimulating vasoconstriction, smooth muscle growth, production of inflammatory cytokines and chemokines, and activating extracellul...