To maintain physical fi tness to perform daily physical activity in the elderly, the circulatory function to perform exercise should be preserved. However, it declines with age and impairs endurance exercise performance in sedentary people. Based upon the concept that exercise capacity should be estimated as ability to continue exercise without serious circulatory stress, a new testing protocol was proposed. It consisted of determining the load for initiation of steeper blood pressure elevation during graded exercise (BP critical of steeper blood pressure elevation during graded exercise (BP critical of steeper blood pressure elevation during graded exercise (BP ). BP critical ). BP critical ). BP decreased with advancing age in sedentary adult people. The decline in BP critical with advancing age in sedentary adult people. The decline in BP critical with advancing age in sedentary adult people. The decline in BP was not related to age-associated change in muscle mass, and was considered to be determined by the changes with age in muscle metabolism and peripheral circulation. To continue exercise, oxygen supply is a key factor and blood fl ow is a major determinant. When the exercising muscle mass was small or the exercise intensity was low, the blood supply to the exercising limb did not differ in older people compared to younger people. In contrast, the vasodilatory response to exercise or to vasodilatory substance was impaired in sedentary older people with concomitant change in vascular structure such as thickening of intima-media thickness, widening of vessel diameter, etc. These age-associated declines in peripheral circulation and vessel structure are prevented by regular exercise, allowing circulatory function to be preserved in the elderly.