Abstract-The known association between physical activity and low blood pressure may be influenced by inherited characteristics. Skeletal muscle consists of type I (slow-twitch) and type II (fast-twitch) muscle fibers, with proportions highly variable between individuals and mostly determined by genetic factors. A high percentage of type I fibers (type I%) has been associated with low blood pressure in cross-sectional studies. We investigated whether type I percentage predicts future blood pressure levels and explains part of the association between physical activity and blood pressure. At baseline, in 1984, muscle fiber-type distribution, physical activity, and body mass index (BMI) were determined in 64 healthy men (age, 32 to 58 years). At follow-up, in 2003, blood pressure, physical activity, and BMI were determined in these men. In subjects without antihypertensive medication (nϭ43), type I percentage accounted for 5%/18% of the variation in systolic/diastolic blood pressure. A high type I percentage predicted, independent of both baseline (in 1984) and follow-up (in 2003), physical activity, BMI, and low systolic and diastolic blood pressure. Adjusted for all baseline covariates, a 20-unit higher type I percentage predicted a 11.6-mm Hg lower systolic blood pressure (Pϭ0.018) and a 5.0-mm Hg lower diastolic blood pressure (Pϭ0.018). High levels of physical activity in 1984 predicted low diastolic blood pressure, but this association was lost when type I percentage was included into the model. A high proportion of type I fibers in skeletal muscle is an independent predictor of low blood pressure and explains part of the known association between high levels of physical activity and low blood pressure. Key Words: blood pressure Ⅲ exercise Ⅲ hypertension Ⅲ muscles H ypertension, an important risk factor for cardiovascular diseases, 1,2 shortens life expectancy. 3,4 Low blood pressure (BP) levels and reduced risk for hypertension are associated with leisure time physical activity (LTPA) and fitness. 5-8 These associations may, however, be influenced by inherited characteristics.BP is the product of cardiac output and total peripheral resistance. 9 Peripheral resistance, and thus also BP, is influenced by the properties of skeletal muscle, more specifically its percentage of type I fibers (type I%). 10 Skeletal muscle consists of type I (slow-twitch) and type II (fast-twitch) muscle fibers. The type I% in the vastus lateralis muscle (the muscle most commonly studied) is highly variable between individuals, ranging from 13% to 96%, with a population mean of Ϸ50%, 11 and is mostly determined by genetic factors. 12 Type I fibers have a higher oxidative capacity than type II fibers. 13 Muscle fiber-type proportions differ between elite athletes in various types of sports. Endurance sports athletes have a high type I%, but speed and power sports athletes have a preponderance of type II fibers. 14 -16 In nonathletes as well, high, mainly endurance-type, LTPA levels are associated with a high type I%. 17,18 Former e...