Randia siamensis is used in Thai folkloric medicine for inducing abortion and controlling blood pressure. The present study investigated the cardiovascular effects of an R. siamensis fruit extract, and mechanisms involved in anesthetized normal and reserpinized rats. R. siamensis (0.4—12 mg/kg) i.v. increased the mean arterial pressure (MAP) and heart rate. Both effects were significantly inhibited by phentolamine (2 mg/kg, i.v.) or propranolol (0.6 mg/kg, i.v.). The combination of phentolamine and propranolol, or reserpine pretreatment, inhibited the positive chronotropic effect with a slight decrease in the MAP. In vitro, R. siamensis (0.001—0.3 mg/ml) increased the rate of beating of the right atrium and the strength of the electrical field-stimulated contraction of the left atrium, both effects were inhibited by propranolol, or with reserpine pretreated rats. R. siamensis (0.01—3 mg/ml) produced a contraction of isolated thoracic aorta, which was potentiated by N^G-nitro-L-arginine (LNA), or by removal of the vascular endothelium, but inhibited by phentolamine, or reserpine. R. siamensis (0.3—3 mg/ml) caused a relaxation of phenylephrine-preconstricted aortic rings, which was potentiated with reserpine pretreatment, and abolished after removal of the vascular endothelium, or in the presence of LNA. These results suggest that R. siamensis extract exerts both hypertensive and positive chronotropic effects via the α- and β-adrenergic receptors of blood vessels and the heart, due to release of endogenous catecholamines, likely from nerve ending and adrenal medulla. The hypotensive activity results from the release of nitric oxide causing dilatation of the blood vessels. The present data support the folkloric therapeutic uses of this plant.