The role of NO in the regulation of the mechanical properties of conduit arteries is controversial in humans, and the involvement of an endothelium-derived hyperpolarizing factor ( EDHF), acting through calcium-activated potassium (K-Ca) channels, has never been investigated at this level in vivo. We assessed in healthy volunteers, after oral administration of aspirin ( 500 mg), the effect of local infusion of N-G-monomethyl-L-arginine (L-NMMA; 8 mu mol/min for 8 minutes), an NO synthase inhibitor, tetraethylammonium chloride ( TEA; 9 mu mol/min for 8 minutes), a K-Ca channels inhibitor, and the combination of both on radial artery internal diameter, wall thickness ( echo tracking), blood flow ( Doppler), and pressure. The incremental elastic modulus and compliance were fitted as functions of midwall stress. L-NMMA decreased modulus and increased compliance at high levels of midwall stress ( all P < 0.05) without affecting radial diameter. TEA reduced radial diameter from 2.68 +/- 0.07 to 2.50 +/- 0.08 10(-3) m, increased the modulus, and decreased the compliance at all levels of stress ( all P < 0.05). Combination of both inhibitors synergistically enhanced the increase in modulus, the decrease in diameter ( from 2.71 +/- 0.10 to 2.42 +/- 0.09 10(-3) m), and compliance compared with TEA alone ( all P < 0.05). These results confirm that inhibition of NO synthesis is associated with a paradoxical isometric smooth muscle relaxation of the radial artery. They demonstrate the involvement of K-Ca channels in the regulation of the mechanical properties of peripheral conduit arteries, supporting a role for EDHF at this level in vivo. Moreover, the synergistic effect of L-NMMA and TEA shows that K-Ca channels compensate for the loss of NO synthesis to maintain peripheral conduit artery diameter and mechanics.