Resistance exercise lowers blood pressure and improves vascular endothelial function in individuals with elevated blood pressure or stage I hypertension.

Lifestyle modifications are the first-line treatment recommendation for elevated blood pressure (BP) or stage 1 hypertension (E/S1H) and include resistance exercise training (RET). The purpose of the current study was to examine the effect of a 9-week RET intervention in line with the current exercise guidelines for individuals with E/S1H on resting peripheral and central BP, vascular endothelial function, central arterial stiffness, autonomic function, and inflammation in middle-aged and older adults (MA/O) with untreated E/S1H. Twenty-six MA/O adults (54±6 y; 16F/10M) with E/S1H engaged in either 9 weeks of 3 days/week RET (n=13) or a non-exercise control (CON; n=13). Pre- and post-intervention measures included peripheral and central systolic (SBP and cSBP) and diastolic BP (DBP and cDBP), flow-mediated dilation (FMD), carotid-femoral pulse wave velocity (cfPWV), cardiovagal baroreflex sensitivity (BRS), cardiac output (CO), total peripheral resistance (TPR), heart rate variability (HRV), and c-reactive protein (CRP). RET caused significant reductions in SBP (mean change [95%CI] = (-7.9 [-12.1,-3.6] mmHg; p <0.001), cSBP (6.8 [-10.8,-2.7] mmHg; p <0.001), DBP (4.8 [-10.3,-1.2] mmHg; p <0.001), and cDBP (-5.1 [-8.9,-1.3] mmHg; p <0.001), increases in FMD (+2.37 [0.61,4.14] %; p= 0.004) and CO (+1.21 [0.26,2.15] L/min; p =0.006) and a reduction in TPR (-398 [-778,-19] mmHg·s/L; p =0.028). RET had no effect on cfPWV, BRS, HRV, or CRP relative to CON ( p ≥0.20). These data suggest that RET reduces BP in MA/O adults with E/S1H alongside increased peripheral vascular function and decreased TPR without affecting cardiovagal function or central arterial stiffness.