BACKGROUND: Hypertension (HTN) exhibits sexual dimorphism; the incidence for women surpasses men during the sixth decade of life, while the pharmacological treatments are less effective and produce more side-effects in women than in men. Aerobic exercise (AE) has been shown to prevent and treat HTN; however, resistance exercise (RE) is not recommended as a strategy to treat HTN. In this study, we investigated the potential sex differences of AE versus RE in a cohort of unmedicated patients with hypertension. METHODS: In total, 40 moderately active, pre-hypertensive or stage 1 essential hypertensive male (M) and female (F) participants aged 40 to 60 years were randomly divided into four groups: MAE, MRE, FAE, and F. Each group exercised at moderate intensity, 3 days/week for 4 weeks. Hemodynamic, vascular and blood-flow data were collected before and after exercise training. RESULTS: Men showed a significant increase in central pulse wave velocity following RE while females showed no significant changes (12 +/- to 13.9 +/- versus 9.2 +/- to 9.6 +/- m/s, respectively). RE showed significantly greater increases in peak blood flow when compared to AE (FRE 15 to 20 versus FAE 17.5 to19.5, MRE 19 to 24 versus MAE 21 to 25 ml/100 ml/min, respectively). In addition, systolic and diastolic BP decreased greater for women following RE when compared to AE whereas men showed comparable decreases in BP following either exercise mode. CONCLUSION: Moderate-intensity RE training may be a more favorable for women as a treatment option for hypertension because of greater decreases in diastolic BP and significant increases in flow-mediated dilation without concomitant increases in arterial stiffness, compared with their male counterparts.

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