Calcitonin gene-related peptide (CGRP) is a 37-amino acid peptide that is a potent coronary vasodilator. Although CGRP is found in high concentrations around coronary arteries, its precise function in the control of coronary vasomotor tone remains unclear. We studied the distribution of specific receptors for CGRP in guinea pig and human hearts and found that the highest concentration of specific receptors for CGRP was in the major coronary arteries, which is consistent with the hypothesis that CGRP is implicated in control of coronary vasomotor tone. Areas of coronary artery with atheroma contained significantly decreased (158 +/- 35 grains/1,000 microns 2 tissue, n = 3) binding sites compared with binding sites in normal arteries (266 +/- 10 grains/1,000 microns 2 tissue, n = 11; p less than 0.001, t test). The decrease in receptors for CGRP around atheroma may predispose these vessels to coronary spasm.