Abstract-Preexisting chronic hypertension complicates up to 5% of pregnancies and is associated with an increased risk of low-birth-weight babies. Studies suggest that an adverse intrauterine environment leading to low birth weight is linked to an increased risk of cardiovascular disease, including hypertension, in the adult. In this study, the blood pressure of offspring from mothers with hypertension were followed up into adulthood. Two-kidney, 1-wrapped hypertension was induced in 7 female rabbits; 5 other rabbits underwent sham surgery. Four weeks later, rabbits were mated, at which time mean arterial pressure was 118Ϯ3 and 87Ϯ5 mm Hg in the hypertensive and sham groups, respectively (PϽ0.001). The blood pressure of 30-week-old females was 89Ϯ2 mm Hg in the offspring of hypertensive (nϭ14) and 79Ϯ1 mm Hg in the offspring of normotensive (nϭ13) mothers (PϽ0.005). Also, plasma renin activity was significantly lower in the female offspring of hypertensive mothers at 10 weeks of age (PϽ0.05), suggesting that development of the renin-angiotensin system was altered. In contrast, male offspring from hypertensive and normotensive mothers had similar mean arterial pressure and plasma renin activity. In conclusion, maternal secondary hypertension can "program" hypertension in female adult offspring. The results also suggest that there are gender-specific differences in sensitivity to altered in utero environmental influences. Key Words: blood pressure Ⅲ rabbits Ⅲ hypertension, secondary Ⅲ pregnancy Ⅲ renin Ⅲ gender H ypertension is the most common complication associated with pregnancy. 1 Preexisting chronic hypertension complicates up to 5% of pregnancies and is associated with an increased risk of preterm labor, uteroplacental insufficiency, placental detachment, and low birth weight. 2,3 In the United States, the percentage of mothers older than 30 years increased from 16% in 1976 to 37% in 2001 4,5 ; it is also known that the rate of hypertension increases in women Ͼ30 years of age. 6 It is therefore predicted that the incidence of chronic hypertension during pregnancy will increase in association with this trend toward childbearing at older ages. Epidemiological studies suggest that an adverse intrauterine environment leading to low birth weight is linked to an increased risk of cardiovascular disease, including hypertension, in the adult. 7,8 Even mild chronic hypertension during pregnancy has been associated with low birth weight. 2,3 We have therefore investigated the effect of chronic hypertension during pregnancy on the blood pressure of adult offspring. To this end, secondary hypertension was induced in female rabbits, these rabbits were mated, and then the blood pressure of their offspring was followed up into adulthood. The adult offspring were also subjected to the prohypertensive physiological challenges of an increased salt diet and weight gain.