Patients with type 2 diabetes present exercise intolerance compared to non diabetic subjects, even without cardiovascular complications. However, the mechanisms responsible for this phenomenon are unknown. PURPOSE: To evaluate the impact of the systolic blood pressure (SBP) on different exercise tolerance parameters in type 2 diabetic patients without cardiovascular complications. METHODS: A total of 28 sedentary men with type 2 diabetes have been recruited to participate in this study. All patients were treated with oral hypoglycaemic agents and/or diet. Evaluation of the glycaemic control (fasting blood glucose and glycated hemoglobin) and the maximal exercise tolerance on an ergocycle were performed for each subject. The subjects were then separated into two groups paired for weight, height and body mass index (BMI) according the median maximal SBP (210 mmHg). RESULTS: Per study design, there was a difference between the maximal SBP between groups (193±16 vs 235±19 mmHg; p<0.001). A reduced increment in SBP (maximal SBP - resting SBP) during exercise was observed in the low SBP group compared to the high SBP group (63±21 vs 98±17 mmHg; p<0.001). We observed a 13%, 13% and 16% reduction in the relative and absolute maximal oxygen uptake (VO2max) and in the maximal work rate in the low compared to the high SBP group [26.95±5.35vs30.96±3.61 ml · kg−1 min−1; 2.5±0.4 vs 2.8±0.6 L · min−1 and 169±34 vs 202±32 watts (all p<0.05)]. An elevated rate-pressure product (SBP × heart rate) was also observed in the high SBP group (39676±5219 vs 30822±4406 mmHg · batt; p<0.001). No difference in the glycaemic control was observed between the 2 groups. Significant relations were present between the absolute VO2 max (r=0.405), maximal exercise time (r=0.414), maximal work rate (r=0.454) and the maximal SBP (all p<0.05). CONCLUSIONS: These results suggest that, in type 2 diabetic patients without cardiovascular complications, an increased afterload does not influence negatively maximal exercise tolerance. Furthermore, the different SBP changes during exercise may not be related to glycaemic control.