Hexarelin is a synthetic analog of ghrelin that binds and activates the ghrelin (GHS) receptor. Hexarelin exhibits cardioprotective, anti-fibrotic, antihypertensive, and anti-fertility activities. In animal models of myocardial infarction, hexarelin protects cardiac function. In spontaneously hypertensive rats, hexarelin prevents deposition of collagen, decreases expression of TIMP-1, collagen I, and collagen III, and increases expression of MMP2 and MMP9, decreasing cardiac fibrosis and blood pressure and attenuating left ventricular hypertrophy. Hexarelin also decreases ovulation and number of offspring produced in vivo.