The present study investigated whether football has favorable effects in the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men. Twenty-five untrained males aged 31-54 year with mild-to-moderate hypertension were randomized to a football training group (FTG, two 1-h sessions per week) and a control group receiving physician-guided traditional recommendations on cardiovascular risk factor modification (doctoral advice group, DAG). After 3 months, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were lowered (P<0.05) by 12 +/- 3 and 7 +/- 1 mmHg in FTG, respectively, whereas no significant changes were observed for DAG, with the 3 months values being lower (P<0.05) in FTG than DAG (SBP: 138 +/- 2 vs 148 +/- 2 mmHg; DBP: 84 +/- 2 vs 92 +/- 2 mmHg). The resting heart rate was lowered (P<0.05) by 12 +/- 2 b.p.m. in FTG after 3 months (67 +/- 3 vs 79 +/- 3 b.p.m.), whereas no change was observed for DAG. After 3 months, FTG had higher (P<0.05) VO(2max) (8 +/- 2%; 35.0 +/- 1.6 vs 32.5 +/- 1.3 mL/min/kg) and lower (P<0.05) fat mass (1.7 +/- 0.6 kg), whereas no change was observed for DAG. In conclusion, football training is an attractive non-pharmacological supplement to the treatment of mild-to-moderate arterial hypertension in untrained middle-aged men.