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Resistance exercise impairs endothelial function, and this impairment is thought to be mediated by sustained elevation in blood pressure. Herein, we tested the hypothesis that resistance exercise-induced endothelial dysfunction would be prevented by high-intensity resistance exercise with low repetitions. This type of resistance exercise is known to induce temporal elevation in blood pressure due to low repetitions and a long resting period between sets. Thirteen young healthy subjects completed three randomized experimental trials as follows: 1) moderate-intensity exercise with moderate repetitions (moderate-moderate trial), 2) low-intensity exercise with high repetitions (low-high trial), and 3) high-intensity exercise with low repetitions (high-low trial). After baseline brachial artery flow-mediated dilation (FMD) and blood pressure measurements, subjects performed resistance exercise according to the different types of trials. Thereafter, brachial artery FMD and blood pressure measurements were repeated 10, 30, and 60 min after the exercise. Exercise-induced increases in blood flow and shear rate were significantly lower in the high-low trial than in the other two trials ( P &lt; 0.05). Although systolic blood pressures were significantly elevated after exercise in all trials ( P &lt; 0.05), the magnitudes of rise in blood pressure increase were significantly lower in the high-low trial than in the moderate-moderate and low-high trials ( P &lt; 0.05). Moderate-moderate and low-high trials caused a significant impairment in brachial artery FMD ( P &lt; 0.05), which could be prevented through high-intensity resistance exercise with low repetitions (  &gt; 0.05). In conclusion, endothelial function was maintained by conducting high-intensity resistance exercise with low repetitions. NEW &amp; NOTEWORTHY Data from the present study reveal that high-intensity resistance exercise with low repetitions can maintain endothelial function. Thus, this study provides the first evidence that the detrimental vascular effects of resistance exercise are preventable when resistance exercise is performed in high intensity with low repetitions. Listen to this article's corresponding podcast at https://ajpheart.podbean.com/e/type-of-resistance-exercise-and-endothelial-function/ (Japanese version: https://ajpheart.podbean.com/e/japanese-language-podcast-type-of-resistance-exercise-and-endothelial-function/ ).

High-intensity resistance exercise with low repetitions maintains endothelial function