Improvement of vascular insulin sensitivity by downregulation of GRK2 mediates exerciseinduced alleviation of hypertension in spontaneously hypertensive rats. Am J Physiol Heart Circ Physiol 305: H1111-H1119, 2013. First published August 2, 2013; doi:10.1152/ajpheart.00290.2013.-Exercise training lowers blood pressure and is a recommended nonpharmacological strategy and useful adjunctive therapy for hypertensive patients. Studies demonstrate that physical activity attenuates progression of hypertension. However, underlying mechanisms remain elusive. Vascular insulin resistance and endothelial dysfunction plays a critical role in the development of hypertension. The present study investigated whether long-term physical exercise starting during the prehypertensive period prevents the development of hypertension via improving vascular insulin sensitivity. Young (4 wk old) prehypertensive spontaneously hypertensive rats (SHRs) and their normotensive Wistar-Kyoto (WKY) control rats were subjected to a 10-wk free-ofloading swim training session (60 min/day, 5 days/wk). Blood pressure, mesenteric arteriolar vasorelaxation, G protein-coupled receptor kinase-2 (GRK2) expression and activity, and insulin-stimulated Akt/ endothelial nitric oxide synthase (eNOS) activation were determined. SHRs had higher systolic blood pressure, systemic insulin resistance, and impaired vasodilator actions of insulin in resistance vessels when compared with WKY rats. Systolic blood pressure in SHRs postexercise was significantly lower than that in sedentary rats. Vascular insulin sensitivity in mesenteric arteries was improved after exercise training as evidenced by an increased vasodilator response to insulin. In addition, exercise downregulated vascular GRK2 expression and activity, which further increased insulin-stimulated vascular Akt/ eNOS activation in exercised SHRs. Specific small interfering RNA knockdown of GRK2 in endothelium mimicked the effect of exerciseenhanced vascular insulin sensitivity. Likewise, upregulation of GRK2 by Chariot-mediated delivery opposed exercise-induced vascular insulin sensitization. Taken together, our results suggest that long-term exercise beginning at the prehypertensive stage improves vascular insulin sensitivity via downregulation of vascular GRK2 that may help to limit the progression of hypertension.hypertension; GRK2; vascular insulin resistance; exercise HYPERTENSION, DEFINED AS blood pressure (BP) at or above 140 mmHg systolic and/or 90 mmHg diastolic, remains one of the most significant modifiable risk factors for cardiovascular diseases, including coronary artery disease, stroke, and heart failure. Although several studies report controversial relationships between BP and physical activity, meta-analysis of randomized controlled trials shows chronic dynamic aerobic endurance training reduces BP (5). Therefore, regular physical exercise is broadly recommended by current European and American hypertension guidelines as first-line therapy. Endurance training decreases BP, in part, through red...