Abstract-Progressive cardiac remodeling is characterized by subsequent chamber hypertrophy, enlargement, and pump dysfunction. It is also associated with increased cardiac fibrosis and matrix turnover. Interestingly, peroxisome proliferator-activated receptor (PPAR) ␣ activators reduce cardiac hypertrophy, inflammation, and fibrosis. Little is known about the role of fenofibrates in mediating PPAR␣-independent effects in response to chronic pressure overload (PO). Wild-type and PPAR␣-deficient mice were subjected to chronic PO caused by ascending aortic constriction to test the role of fenofibrates in chronic, progressive cardiac remodeling by a PPAR␣-independent mechanism. Mice were randomized to regular chow or chow-containing fenofibrate (100 mg/kg of body weight per day) for 1 week before and 8 weeks after ascending aortic constriction. In the presence of PPAR␣, wild-type chronic PO mice, treated with fenofibrate, had improved cardiac remodeling. However, PO PPAR␣-deficient mice treated with fenofibrate had increased mortality, significantly adverse left ventricular end diastolic (3.4Ϯ0.1 versus 4.2Ϯ0.1 mm) and end systolic (1.5Ϯ0.2 versus 2.5Ϯ0.2 mm) dimensions, and fractional shortening (57Ϯ3% versus 40Ϯ3%). Fenofibrate also increased myocardial hypertrophy, cardiac fibrosis, and the ratio of matrix metalloproteinase-2/tissue inhibitor of matrix metalloproteinase-2 in PO PPAR␣-deficient mice. Fenofibrate inhibited matrix metalloproteinase activity in vitro and aldosterone-induced increases in extracellular signal-regulated kinase phosphorylation. Thus, fenofibrate improved cardiac remodeling in chronic PO mice. However, in PPAR␣-deficient mice, this chronic PO was exacerbated and associated with increased myocardial fibrosis and altered matrix remodeling. In the absence of PPAR␣, fenofibrates exerts deleterious, pleiotropic myocardial actions. This is an important observation, because PPAR␣ agonists are considered possible inhibitory regulators of cardiac remodeling in the remodeled heart. (Hypertension. 2007; 49:1084-1094.)