A group of 45 male subjects were examined in a cross-sectional study to compare the blood pressure response that occurs during isometric exercise maintained to fatigue among control subjects and paraplegic patients with (PH) and without essential hypertension (PN). Two muscle groups were examined: the handgrip muscles (voluntary effort) and the quadriceps muscles. The tension chosen for the contraction was 40% of the muscles maximum strength for both muscle groups. While the paraplegic groups had more strength in their handgrip muscles than that found for the controls, the control subjects had more strength in their quadriceps muscles than either of the paraplegic groups. During the fatiguing isometric contractions, the rate of rise and absolute systolic blood pressure was higher in the PH than the other groups of subjects. The diastolic pressure of the PH group, while elevated during exercise, was only elevated to the same degree as the increase in resting diastolic pressure above normal. Heart rate changes during exercise was the same in all groups of subjects for handgrip contractions. The controls had the same heart rate response to handgrip as to leg exercise. The paraplegic groups showed no heart rate change during fatiguing contractions of their quadriceps muscles. The PH group actually showed a reduction in heart rate during the leg exercise.