Abstract-We tested the hypothesis that female and male mice differ in terms of cardiac hypertrophy after deoxycorticosterone acetate (DOCA)ϩsalt hypertension (uninephrectomy and 1% saline in drinking water) and focused on calcineurin signaling. We excluded confounding effects of blood pressure elevation or sex-related blood pressure differences by treating DOCA-salt mice with hydralazine (250 mg/L in drinking water). We found that directly measured mean arterial blood pressure was lowered to control values with hydralazine and corroborated this finding in separate mouse groups with radiotelemetry. Male mice were more responsive to DOCA-salt-related effects. They developed more left ventricular hypertrophy and more renal hypertrophy after 6 weeks of DOCA-saltϩhydralazine compared with female mice. In hearts, transcripts for calcineurin A and for myocyte-enriched calcineurin interacting protein 1 were upregulated in male but not in female mice. Enhanced activity of calcineurin A, as indicated by diminished phosphorylation of NFATc2 in male mice, accounted for this sex-specific difference. Stretch-related, inflammatory, and profibrotic responses were also accentuated in male mice, as shown by higher transcript levels of atrial natriuretic peptide, monocyte chemoattractant protein-1, and transforming growth factor-. Our results support sex-specific regulation of the calcineurin pathway in response to largely blood pressure-independent mineralocorticoid action. We suggest that sex-specific calcineurin activation determines the maladaptive cardiac and renal hypertrophic responses and accompanying organ injury in male mice. Key Words: heart Ⅲ kidney Ⅲ hypertrophy Ⅲ inflammation Ⅲ fibrosis Ⅲ calcineurin Ⅲ MCIP1 Ⅲ NFATc2 S ex differences in cardiac 1 and renal 2 function are well established. Women have a lower overall incidence of left ventricular (LV) hypertrophy 3 and nondiabetic renal disease than men. 4 Less pronounced injury in female animals has been attributed to estradiol-mediated protective effects. 5 Male vulnerability was related to detrimental effects of androgens. 6 Gonadal steroids regulate renal and systemic hemodynamics, as well as renal sodium handling. 7 Chronic salt overload is a major cardiovascular stressor that sets in motion a series of adaptive processes in hearts and kidneys in patients with renal dysfunction. 8,9 Deoxycorticosterone acetate (DOCA)ϩsalt acts similarly to aldosterone, promotes sodium retention and potassium excretion in the distal nephron, and serves as a "prototype" model for salt-sensitive low-renin hypertension. 10 Rats or mice with DOCA-salt hypertension develop sex-specific differences in cardiorenal target-organ damage that are mainly attributed to more delayed and less extensive blood pressure increases in females compared with males. 11 Whether sex-specific differences in cardiorenal damage still exist in the context of independent systemic blood pressure responses to salt overload has not been studied. We hypothesized that female mice have endogenous compensatory mech...