Increased apoptosis has been demonstrated in various forms of human and experimental cardiovascular disease. The role of this phenomenon in the vasculature in different models of hypertension is unclear. In hypertension, regression of vessel wall hypertrophy/hyperplasia or remodeling in response to various antihypertensive drugs may be mediated in part by apoptosis. This study examined vascular smooth muscle apoptosis in spontaneously hypertensive rats (SHR), in which it may presumably counterbalance vascular wall growth. Angiotensin converting enzyme (ACE) inhibitors and calcium channel blockers induce regression of the vascular wall in hypertension. Therefore, we investigated the effect of the ACE inhibitor enalapril and the dihydropyridine calcium channel blocker amlodipine on apoptosis in blood vessels of SHR to determine whether part of the growth inhibitory effect of these drugs is mediated by apoptosis. This was performed by detection and measurement of DNA fragmentation using DNA laddering and examining aortic histologic sections with in situ end-labeling (terminal deoxynucleotide transferase-mediated dUTP-nick labeling [TUNEL]). Ten-week-old SHR were treated for 12 weeks with 10 mg/kg per day of enalapril and 20 mg/kg per day of amlodipine. Blood pressure was significantly reduced by enalapril and amlodipine (P < .01). Cross-sectional area of aorta was significantly increased (3.34+/-0.15 mm2) in SHR compared to that of Wistar-Kyoto (WKY) control rats (1.17+/-0.07 mm2, P < .01). The cross-sectional area of the aorta was significantly smaller in enalapril-treated SHR (2.42+/-0.12 mm2, P < .05) compared to untreated SHR, and almost normalized by amlodipine (1.65+/-0.31 mm2, P < .01). Apoptosis characterized using terminal deoxynucleotidyl transferase to radiolabel 3'-OH ends of fragmented DNA extracted from aorta, showed presence of fragmented labeled DNA as "DNA laddering," a hallmark of apoptosis. SHR had increased apoptosis (341+/-25 pixels/microg DNA) compared to WKY controls (206+/-13 pixels/microg DNA, P < .01). Apoptosis was six- to eightfold greater in aorta of enalapril and amlodipine-treated SHR (P < .01). These results were confirmed by in situ end-labeling of fragmented DNA in aortic histologic sections. Western blot quantification of Bax and Bcl-2 (pro- and antiapoptotic gene products, respectively) showed higher Bax and lower Bcl-2 expression, and accordingly increased the Bax-to-Bcl-2 ratio in aorta from SHR treated with enalapril or amlodipine in comparison to untreated SHR. In conclusion, enhanced apoptosis is present in aorta of SHR, possibly as a homeostatic mechanism counterbalancing growth. Antihypertensive agents such as the ACE inhibitor enalapril and the calcium antagonist amlodipine may cause regression or inhibition of vascular wall growth in SHR partly through enhanced apoptosis, which may contribute to the antihypertensive effects of these drugs.