Obesity has been considered a risk factor among the precursors of essential hypertension for many years. Most related studies were general population surveys or predominantly white, male cohorts. This paper reports results of a longitudinal study of former black medical students, now practicing physicians for an average of 22.5 years. A remarkably high 43.8% were found to have developed hypertension. Fifty nine per cent of those who became obese during the study were hypertensive compared with 40% of the non-obese, 36% of those initially obese only, and 45% of those obese on both examinations. The risk ratio was 1.7 for the most obese (greater than or equal to 130% relative body weight) compared with 1.0 for the leanest group Dynamic weight change together with baseline diastolic blood pressure, were more prominent precursors than the other variables studied. Weight control would appear to be a potentially important nonpharmacologic hypertension risk reduction measure.
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