Background: Hypertension is a cause of premature death. One of the treatments for high blood pressure is regular exercise. In addition, it is a safe exercise, less injuries and can be easily implemented. Exercise with the ball is a very interesting type of exercise to apply for health promotion that believed to improve blood pressure and functional performance in hypertensive patients.

Objective: To determine the effects of exercise with the ball on blood pressure and functional performance in female hypertensive patients.

Methods: In a randomized controlled trial, female hypertensive patients (n = 20; average age 50.8  3.3 years) were randomly allocated into two groups. The experimental group performed exercise with the ball consisted of 55 minutes/time, 3 times a week for 6 weeks whereas the control group received education. Blood pressure measured by digital sphygmomanometers. Functional performance tests were assessed cardiovascular endurance measured by 6 minutes walk test, balance control, gait and lower extremity strength measured by timed up and go test, gait speed measured by 10-meter walk test and postural control measured by one leg stand test. Results were presented as means and standard deviations.

Results: At the end of the study, there were significantly differences between experimental and control group for systolic and diastolic blood pressure (P < 0.05), respectively. Functional performance in experimental group were improved for 6 minutes walk test (P < 0.05), time up and go test (P < 0.05), 10-meter walk test (P < 0.05) and one leg stand test (P < 0.05).

Conclusions: Exercise with the ball can reduce blood pressure levels and improve functional performance. These findings support the recommendations of exercise with the ball in hypertensive patients.