To study the effects of strength training versus aerobic exercise on microvascular as well as macrovascular function in patients with RA. Forty age-, sex-, and BMI-matched RA patients were enrolled in the study and divided into two groups: one group received moderate aerobic and strength training for 6 months, and one group was only informed of the benefits of exercise. Microvascular function (Ach and SNP) and macrovascular function (flow-mediated dilation and glyceryl trinitrate), maximal oxygen uptake, disease activity, and severity (CRP, DAS28, and HAQ questionnaire) were evaluated. Data were collected at baseline, 3 months, and 6 months at endpoint. Results showed that baseline demographic characteristics, anthropometric and disease-related characteristics, and parameters related to endothelial function were similar (p>0.05). Repeated measures analysis of the variables suggested significant improvements in endothelial function parameters at 3 months (GTN: p<0.001) and 6 months (Ach:p=0.016, SNP: p=0.045, FMD: p=0.016) in the exercise group and no change in the control group. Generalized estimating equations showed that maximal oxygen uptake was a strong predictor of changes in ACH (p=0.009) as well as GTN (p<0.001), while logcrp was a predictor of snp (p=0.017) as well as gtn (p=0.008). The conclusions show that a tailored exercise program significantly improves microvascular as well as macrovascular function in RA patients. The potential long-term benefits of physical training for reducing cardiovascular risk in patients need further study.