Abstract—Hypertension is strongly related to cardiovascular disease and all-cause mortality. Exercise reduces blood pressure but the response varies between individuals. The mechanisms by which physical activity energy expenditure (PAEE) modifies blood pressure are not fully defined but include modulation of sympathetic tone. Novel polymorphisms in the G-protein coupled receptor (GPR10) have been linked with high blood pressure. GPR10 may mediate the relationship between PAEE and blood pressure via central nervous mechanisms. We examined whether two GPR10 polymorphisms (G-62A and C914T) modify the association between PAEE and blood pressure in the MRC Ely study (N=687). When stratified by the C914T genotype, there were between-group differences for body mass index (BMI) (P=0.05), diastolic blood pressure (DBP) (P=0.006), and systolic blood pressure (SBP) (P=0.005). No differences were found betweenG-62A genotypes. The previously reported inverse relationship between PAEE and blood pressure was not observed in minor allele carriers for either polymorphism (A62 carriers: DBP &bgr;-1.11,P=0.52; SBP &bgr;-1.66,P=0.52. T914 carriers: SBP &bgr;=3.27;P=0.60) but was in common allele homozygotes (G62G: DBP &bgr;-6.18P=0.00001; SBP &bgr;-8.54P=0.0001. C914C: SBP &bgr;-7.07;P=0.00001). This corresponded to a significant interaction between PAEE and GPR10 polymorphisms on DBP (G-62A:P=0.006) and SBP (G-62A:P=0.008. C914T:P=0.068). Significant interactions were observed between haplotype (derived fromG-62A and C914T), PAEE, and blood pressure (DBP:P=0.08; SBP:P=0.023). The effect of physical activity on blood pressure is highly variable at population level. Knowledge of GPR10 genotype may define those who are least likely to benefit from physical activity. These findings may have relevance in the targeted treatment of hypertensive disease.