The health benefits of aerobic exercise have been well established, with less data existing on the benefits of resistance exercise. Furthermore, most early studies on physical activity and hypertension investigated either aerobic or resistance training alone, and have primarily been done on healthy individuals. Therefore, data on individuals who are hypertensive, overweight or obese, sedentary, and at an increased risk for cardiovascular disease are scarce. Purpose: The purpose of this study was to compare the effects of aerobic training only, resistance training only, and a combination of both on blood pressure and other cardiovascular disease risk factors compared with a non-exercising control group. Methods: Pre- or stage-1 hypertensive, overweight or obese, and sedentary men and women (ages 58 ± 7 years) were randomized to one of three 8-week exercise programs (aerobic only, resistance only, or a combination of both), or a non-exercise control group. The exercise programs were all 3 days per week for 1 hour. Results: Of the 69 randomized participants, 66 completed the protocol and all 69 were used in an intention-to-treat analysis. At baseline, the mean (SE) for systolic and diastolic blood pressure was 131 (13) mmHg and 91 (9) mmHg, respectively. Eight weeks of exercise did not significantly change systolic blood pressure in any of the groups (p > 0.05), and only the combination group saw a significant decrease in diastolic blood pressure (-3.7 mmHg, 95% CI -6.8, -0.6). Significant increases [mean (95% CI); p value] were also seen in treadmill time for the aerobic [72 seconds (38, 107); p <0.01] and combination groups [51 seconds (17, 86); p <0.01], whereas significant lower body strength gains were seen in the resistance [29.4 lbs (9.1, 49.7); p=0.01] and combination groups [24.4 lbs (4.7, 44.2); p=0.02]. Lastly, significant improvements [mean (95% CI; p value)] in body composition were seen for all three exercise groups: aerobic [weight: -1.0 kg (-1.9, -0.1; p=0.03) and fat mass -0.9 kg (-1.5, -0.2; p=0.01)], resistance [waist circumference: -1.7 cm (-3.3, -0.1; p=0.04)], and combination [weight 0.9 kg (0.02, 1.8; p=0.04) and lean body mass 0.8 kg (0.0, 1.5; p=0.04)]. Conclusion: Overall, the combination of aerobic and resistance exercise training seemed to be the most effective in improving blood pressure and other cardiovascular disease risk factors.