Abstract-The renin-angiotensin system regulates cardiovascular physiology via angiotensin II engaging the angiotensin type 1 or type 2 receptors. Classic actions are type 1 receptor mediated, whereas the type 2 receptor may counteract type 1 receptor activity. Angiotensin-converting enzyme 2 metabolizes angiotensin II to angiotensin-(1-7) and angiotensin I to angiotensin-(1-9). Angiotensin-(1-7) antagonizes angiotensin II actions via the receptor Mas. Angiotensin-(1-9) was shown recently to block cardiomyocyte hypertrophy via the angiotensin type 2 receptor. Here, we investigated in vivo effects of angiotensin-(1-9) via the angiotensin type 2 receptor. Angiotensin-(1-9) (100 ng/kg per minute) with or without the angiotensin type 2 receptor antagonist PD123 319 (100 ng/kg per minute) or PD123 319 alone was infused via osmotic minipump for 4 weeks into stroke-prone spontaneously hypertensive rats. We measured blood pressure by radiotelemetry and cardiac structure and function by echocardiography. Angiotensin-(1-9) did not affect blood pressure or left ventricular mass index but reduced cardiac fibrosis by 50% (PϽ0.01) through modulating collagen I expression, reversed by PD123 319 coinfusion. In addition, angiotensin-(1-9) inhibited fibroblast proliferation in vitro in a PD123 319-sensitive manner. Aortic myography revealed that angiotensin-(1-9) significantly increased contraction to phenylephrine compared with controls after N-nitro-L-arginine methyl ester treatment, an effect abolished by PD123 319 coinfusion (area under the curve: angiotensin-(1-9) N-nitro-L-arginine methyl esterϭ98.9Ϯ11.8%; controlϩN-nitro-Larginine methyl esterϭ74.0Ϯ10.4%; PϽ0.01), suggesting that angiotensin-(1-9) improved basal NO bioavailability in an angiotensin type 2 receptor-sensitive manner. In summary, angiotensin-(1-9) reduced cardiac fibrosis and altered aortic contraction via the angiotensin type 2 receptor supporting a direct role for angiotensin-(1-9) in the reninangiotensin system. (Hypertension. 2012;59:300-307.) • Online Data Supplement Key Words: renin-angiotensin system Ⅲ angiotensin-(1-9) Ⅲ cardiac fibrosis Ⅲ angiotensin type 2 receptor Ⅲ stroke-prone spontaneously hypertensive rat A ngiotensin II (Ang II) is the main effector of the renin-angiotensin system (RAS), classically acting via the angiotensin type 1 receptor (AT 1 R) to stimulate effects such as sodium reabsorption, vasoconstriction, proliferation, and inflammation. Ang II, acting via the AT 1 R, contributes to the pathophysiology of cardiovascular disease. The angiotensin type 2 receptor (AT 2 R) is 34% homologous to the AT 1 R, 1 and its actions differ. 2,3 AT 2 R expression is limited to fetal/neonatal tissues 4 ; however, in adult rodents it is upregulated in heart failure and postmyocardial infarction. 5 In human adult myocardium, 41% of angiotensin binding sites are AT 2 Rs. 5 Ang II signaling via the AT 2 R counteracts AT 1 R signaling; for example, blocking AT 2 R activation promotes cardiomyocyte hypertrophy, 2 whereas AT 2 R overexpression in stroke-p...