The highly effective anorexigen (ϩ)-fenfluramine was widely used to control body weight until the association with primary pulmonary hypertension and valvular heart disease. (ϩ)-Norfenfluramine is the major hepatic metabolite of (ϩ)-fenfluramine and is primarily responsible for the anorexic effect as well as side effects. We reported that (ϩ)-norfenfluramine causes vasoconstriction and a blood pressure increase in rats with normal blood pressure via the 5-hydroxytryptamine (5-HT) 2A receptor. With the knowledge that (ϩ)-norfenfluramine also has affinity for 5-HT 2B receptors and that arterial 5-HT 2B receptor expression is up-regulated in deoxycorticosterone acetate (DOCA)-salt hypertension, we tested the hypothesis that (ϩ)-norfenfluramine-induced vasoconstriction and pressor effects are potentiated in DOCA-salt hypertensive rats in a 5-HT 2 receptor-dependent manner. Contractions of arteries were measured using an isolated tissue bath system or myograph. Mean arterial blood pressure was measured in chronically instrumented conscious rats. Effects of (ϩ)-norfenfluramine in stimulating arterial contraction (leftward shift versus SHAM, aorta, 5.13-fold; renal artery, 1.95-fold; mesenteric resistance artery, 1.77-fold) and raising blood pressure were significantly enhanced in hypertension. In arteries from both normotensive and hypertensive rats, (ϩ)-norfenfluramine-induced contraction in aorta was inhibited by 5-HT 2A receptor antagonists, ketanserin and LY53857 (4-isopropyl-7-methyl-9-(2-hydroxy-1-meth ylpropoxycarbonyl) 4,6,6a,7,8,9,10,10a-octahydroindolo[4,3-fg]quinoline), but not by the 5-HT 2B receptor antagonist, LY272015 [6-chloro-5-methyl-N-(5-quinolinyl)-2,3-dihydro-1H-indole-1-carboxamide]. Ketanserin (3 mg/kg) reduced (ϩ)-norfenfluramine-induced pressor response in both SHAM and DOCA rats. Our results demonstrate that (ϩ)-norfenfluramineinduced arterial contraction and blood pressure increases are potentiated in DOCA-salt hypertensive rats. However, it is the 5-HT 2A receptor and not the 5-HT 2B receptor that participates in these effects.The highly effective anorexigen (ϩ)-fenfluramine (Redux) was taken off the market in 1997 because of the incidence of pulmonary hypertension (Abenhaim et al., 1996) and aortic valvular disease (Connolly et al., 1997). The anorexic effect of (ϩ)-fenfluramine is due to activation of 5-hydroxytryptamine (5-HT) 2C receptor (Smith et al., 2006), whereas the 5-HT 2B receptor plays an important role in the pathogenesis of (ϩ)-fenfluramine-induced pulmonary hypertension (Launay et al., 2002) and aortic valvular disease (Fitzgerald et al., 2000).Radioligand binding experiments show that (ϩ)-fenfluramine has low affinity for the 5-HT 2A , 5-HT 2B , and 5-HT 2C receptors, but the hepatic deethylated metabolite of (ϩ)-fenfluramine, (ϩ)-norfenfluramine, has high affinity at the 5-HT 2B receptor (K i ϭ 11.2 nM), 5-HT 2C receptor (K i ϭ 324 nM) and a lesser affinity at the 5-HT 2A receptor (K i ϭ 1516 nM) (Rothman et al., 2000). Consistent with binding results, two studies s...