We investigated the link between changes in body composition and the blood pressure (BP) response to exercise in overweight Japanese by a retrospective clinical study carried out over a 3-year period. We analyzed data for 38 overweight Japanese aged 22-69 years (47.8 +- 11.4) at baseline. Among the participants, 32 overweight subjects (body mass index : BMI, 29.0 +- 3.0 kg/m2) were further analyzed with a 3-year follow up. BP at rest, the BP response to an exercise test, the aerobic exercise-level determined ventilatory threshold (VT), and body composition were evaluated at an interval of 1 year. During the study period, there were 6 drop outs, who started to receive anti-hypertensive drugs because of the development of hypertension. Based on analysis of follow up data, parameters of body composition were significantly reduced over the 3 years. Systolic BP (SBP) at rest and at VT was also reduced. In addition, delta SBP (Delta: delta represents positive change in parameters) at VT was positively correlated with Delta parameters of body composition over the 3 years. In overweight subjects with increased body weight, there was a significant time (pre vs year 3) effect and interactions by 2 factor-factorial ANOVA. The present study indicates that changes in body composition are closely linked to the SBP response to an exercise test.