Background Continuous production of nitric oxide (NO) from endothelial cells permanently inhibits the synthesis and the vasoconstrictor effects of endothelin. Thus, inhibition of NO synthesis might unmask a vasopressor response to endothelin. To assess whether endothelin contributes to the presser response induced by inhibition of NO synthesis, we tested whether bosentan, a nonpeptide antagonist of ET(A) and ET(B) endothelin receptors, affected the hypertensive response in duced by the NO synthase inhibitor N-G-nitro L-arginine methyl ester (L-NAME). Methods and Results Anesthetized rats received increasing doses of L-NAME (9.1 to 3 mg.kg(-1)) in the absence or the presence of bosentan (3 mg.kg(-1) IV 15 minutes before L-NAME). Bosentan itself did not affect blood pressure. L-NAME induced a dose-dependent increase in mean arterial pressure (percent increase from baseline after 3 mg.kg(-1), 25+/-5%), and this was reduced by bosentan (13+/-3%; P<.05) or by the selective ET(A) antagonist BQ-123 (3 mg.kg(-1): controls, 25+/-4%; BQ-123, 14+/-5%; P<.01). In contrast, bosentan did not affect the presser response to phenylephrine (1 to 100 mu g kg(-1)). The response to L-NAME (3 mg.kg(-1)) was also reduced by bosentan in ganglion-blocked (chlorisondamine 2.5 mg.kg(-1): controls, 89+/-10%; bosentan, 45+/-7%) or pithed rats (controls, 165 +/-9%; bosentan, 85+/-12%; P<.01). Bosentan also inhibited the presser response to another inhibitor of NO synthesis, N-G-nitro L-arginine (3 mg.kg(-1)) in normal (controls, 24+/-5%; bosentan, 10+/-3%; P<.01) or ganglion-blocked (controls, 86+/-13%; bosentan, 25+/-8%; P<.01) rats. Finally, L-NAME induced a modest increase in plasma levels of endothelin-1 (controls, 26.8+/-4.1 pg mL(-1); L-NAME, 38.5+/-3.3 pg mL(-1); P<.05). Conclusions These experiments demonstrate that inhibition of NO synthesis unmasks a tonic presser influence of endothelin, suggesting that this peptide could play a major role in pathophysiological situations associated with an impaired formation of NO.