Thus, although exercise is effective in improving FMD in hypertensive patients, the impact of improved endothelial function is limited due to hypertension-mediated mechanical stress leading to elastin disruption, collagen deposition, and fibrosis, which leads to progressive arterial stiffness (96), and this chronic sclerosis may take longer to improve or even be irreversible. This evidence concerns the gene ELN and Hypertension.