Parasympathetic activity is often reduced in hypertension and can elicit anti-inflammatory mechanisms. Thus we hypothesized that chronic vagal nerve stimulation (VNS) may alleviate cardiovascular end-organ damage in strokeprone spontaneously hypertensive rats. Vagal nerve stimulators were implanted, a high-salt diet initiated, and the stimulators turned on (VNS, n = 10) or left off (sham, n = 14) for 4 wk. Arterial pressure increased equally in both groups. After 4 wk, endothelial function, assessed by in vivo imaging of the long posterior ciliary artery (LPCA) after stimulation (pilocarpine) and inhibition (N-omega-nitro-L-arginine methyl ester) of endothelial nitric oxide synthase (eNOS), had significantly declined (-2.3 +/- 1.2 mu m, P < 0.05) in sham, but was maintained (-0.7 +/- 0.8 mu m, nonsignificant) in VNS. Furthermore, aortic eNOS activation (phosphorylated to total eNOS protein content ratio) was greater in VNS (0.83 +/- 0.07) than in sham (0.47 +/- 0.08, P < 0.05). After only 3 wk, ultrasound imaging of the aorta demonstrated decreased aortic strain (-9.7 +/- 2.2%, P < 0.05) and distensibility (-2.39 +/- 0.49 1,000/mmHg, P < 0.05) and increased pulse-wave velocity (+2.4 +/- 0.7 m/s, P < 0.05) in sham but not in VNS (-3.8 +/- 3.8%, +/- 0.70 +/- 1.4 1,000/mmHg, and +0.1 +/- 0.7 m/s, all nonsignificant). Interleukin (IL)-6 serum concentrations tended to be higher in VNS than in sham (34.3 +/- 8.3 vs. 16.1 +/- 4.6 pg/ml, P = 0.06), and positive correlations were found between NO-dependent relaxation of the LPCA and serum levels of IL-6 (r = +0.70, P < 0.05) and IL-10 (r = +0.56, P < 0.05) and between aortic eNOS activation and IL-10 (r = +0.48, P < 0.05). In conclusion, chronic VNS prevents hypertension-induced endothelial dysfunction and aortic stiffening in an animal model of severe hypertension. We speculate that anti-inflammatory mechanisms may contribute to these effects. Listen to this article's corresponding podcast at http://ajpheart.podbean.com/e/chronic-vagal-nerve-stimulation-in-stroke-prone-shr/.