This study aimed to investigate the effects of a 16-week aerobic exercise program on systolic blood pressure, intracellular cell adhesion molecule-1, vascular cell adhesion molecule-1, and oxidized low-density lipoprotein of obese and nonobese elderly women with isolated systolic hypertension. Elderly women aged 70-85 years were recruited and grouped into the normal isolated systolic hypertension (n = 12) and obese isolated systolic hypertension groups (n = 13). The participants followed an aerobic exercise program, using a wireless heart rate monitor to maintain an appropriate heart rate reserve based on the American College of Sports Medicine exercise guidelines. The two-way repeated measures analysis of variance tested group × time interaction. Pearson's correlation and simple regression assessed the influence of each variable, which showed significant differences. :An interaction effect for systolic blood pressure, intracellular cell adhesion molecule-1, and vascular cell adhesion molecule-1 (P < 0.05) and a main time effect for oxidized low-density lipoprotein (P < 0.05) were observed. A correlation between the rates of change in systolic blood pressure and vascular cell adhesion molecule-1 (P < 0.05) with a 42.8% influence (P < 0.001) and in intracellular cell adhesion molecule-1 and vascular cell adhesion molecule-1 (P < 0.05) with a 21.6% influence (P < 0.05) was observed. These findings collectively showed that the 16-week aerobic exercise program effectively lowered blood pressure in patients with isolated systolic hypertension, particularly in the normal group compared to the obese group. Thus, regular aerobic exercise for 16 weeks or more enhances vascular health, potentially improving the healthy life expectancy of elderly women.