Carbonic anhydrase (CA)‐II exacerbates cardiomyocyte hypertrophy and death in vitro. A, CA‐II overexpression in neonatal and adult cardiomyocytes (nCMs and arCMs, respectively); *P<0.001 vs control empty plasmid (CON). B, Effects of normal/low glucose (CON), high glucose (HG), CA‐II overexpression, CA‐II inhibition by ETZ, and specific NHE‐1 inhibitor (NHE‐1‐i) on nCM cell size; *P<0.004 vs CON, ETZ, HG+ETZ, NHE‐1‐i and CA‐II+NHE‐1‐i. When not specified, drug treated cells were grown in normal/low glucose. C, Effects of normal/low glucose (CON), high glucose, CA‐II overexpression, CA‐II inhibition by ETZ, and specific NHE‐1 inhibitor (NHE‐1‐i) on nCM hypertrophic growth assessed by [3H]leucine incorporation; *P<0.001 vs CON, ETZ, HG+ETZ, NHE‐1‐I, and CA‐II+NHE‐1i. D, Effects of normal/low glucose (CON), high glucose, CA‐II overexpression, CA‐II inhibition by ETZ, and specific NHE‐1 inhibitor (NHE‐1‐i) on ANF, BNP and β‐MHC mRNA levels in nCMs; *P<0.001 vs CON, ETZ, HG+ETZ, NHE‐1‐i and CA‐II+NHE‐1i. E, Effects of normal/low glucose (CON), high glucose, CA‐II overexpression, CA‐II inhibition by ETZ, and specific NHE‐1 inhibitor (NHE‐1‐i) on arCM apoptosis; *P<0.001 vs CON, ETZ, HG+ETZ, NHE‐1‐i and CA‐II+NHE‐1i. F, Effects of scrambled control shRNA (CTRLshRNA) and specific CA‐II shRNA (CA‐IIshRNA) on glucose‐induced NHE‐1 phosphorylation. All quantitative data are from 4 independent experiments. Quantitative data are expressed as mean±SE. EZT indicates 6‐ethoxyzolamide; NHE‐1, sodium‐hydrogen exchanger‐1.