Resistant hypertension (RH), defined as a high blood pressure that remains uncontrolled despite treatment, is still a major medical challenge. During the last decade, several studies have demonstrated the promising effects of exercise on the category of hypertensives. This review summarizes the existing literature on the effects of exercise therapy on patients with RH. From the literature search conducted in PubMed (January 1980 to December 2023), 12 papers (6 with acute- and 6 with chronic exercise) were selected. Despite the few studies, the acute hemodynamic burden and the post-exercise response in patients with RH were within clinically acceptable limits and may vary according to the intensity and duration of the exercise protocols. Chronic exercise, especially warm-water exercise, effectively lowers blood pressure in patients with RH without serious adverse events or complications. Based on recent scientific evidence, patients with RH need to change their lifestyle by adopting systematic exercise for the optimal treatment of their disease. Future investigations are required to explore the exact exercise mechanisms that benefit patients with RH.

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