Background: Arterial hypertension and increased blood pressure variability (BPV) are major prognostic determinants in patients with ischemic heart disease (IHD). While exercise training is known to improve blood pressure (BP) control, the effects of different combined exercise modalities on BPV in IHD remain poorly defined. This randomized pilot study compared the effects of continuous combined training (CCT; moderate-intensity continuous aerobic exercise plus resistance training) and interval combined training (ICT; high-intensity interval aerobic exercise plus resistance training) on BPV and BP parameters in hypertensive patients with IHD. Methods: Thirty-six clinically stable patients with IHD and hypertension were randomized to CCT or ICT for 12 weeks. Outcomes included short-term BPV assessed by 24-hour ambulatory BP monitoring, resting and 24-hour BP, and exercise capacity. Results: Short-term systolic BPV significantly decreased in the CCT group but remained unchanged in the ICT group: [adjusted between-group difference −2.1 mmHg (95% CI: −4.1 to −0.1; p 0.029]. Resting systolic BP decreased similarly in both groups, whereas no significant changes were observed in 24-hour BP values. Peak oxygen uptake improved in both groups with a greater increase in the ICT group [adjusted between-groups difference +1.7 mL·kg⁻¹·min⁻¹ (95% CI: 0.7 to 2.8); p = 0.032). Conclusion: These findings suggest that, in patients with IHD, continuous combined training may be more effective than interval combined training in reducing short-term BPV, whereas interval training may confer greater improvements in aerobic capacity. Further adequately powered studies are warranted to confirm these results.