Resistance training is a popular mode of exercise, but may result in stiffening of the central arteries. Changes in carotid artery diameter were determined using the cold pressor test (CPT), which results in production of nitric oxide via sympathetic activation and is one of the novel methods available for assessing endothelial function in the carotid artery. To investigate the effect of resistance training on endothelial function, we designed a cross-sectional study of carotid arterial vasoreactivity to CPT in men participating in regular resistance training with increased carotid arterial stiffness compared with age-matched control subjects. Twelve resistance-trained middle-aged men (age 38.7 +/- 1.7 years) and 17 age-matched control subjects (age 36.8 +/- 1.2 years) were studied. The direction and magnitude of changes in carotid artery diameter were measured by B-mode ultrasonography during sympathetic stress induced by submersion of the foot in ice slush for 90 s. Carotid arterial beta-stiffness index, and systolic and mean arterial blood pressure were higher (7.7 +/- 0.7 versus 6.0 +/- 0.4 arbitrary units, 116 +/- 2 versus 131 +/- 4 mmHg and 86 +/- 2 versus 95 +/- 2 mmHg, respectively, all P < 0.05) in the resistance training group compared with control subjects. There were, however, no significant differences in the amount or percentage change in carotid artery diameter in CPT between the two groups (resistance training group, 0.33 +/- 0.07 mm and 5.2 +/- 1.1%; control group, 0.37 +/- 0.06 mm and 5.8 +/- 0.9%, respectively). These findings suggest that while carotid arterial stiffening and higher blood pressure are observed in regular resistance-trained men, these are not associated with abnormalities in carotid arterial vasoreactivity to sympathetic stimulus, which implies intact endothelial function.