Substantial evidence from epidemiological data supports a link between obesity and hypertension. However, the relationship between the two disorders is not straightforward, and most likely represents the interaction of demographic, genetic, hormonal, renal, and hemodynamic factors. In the obese patient, hypertension can be reversed by weight loss. Furthermore, weight loss can prevent, or at least delay, the development of hypertension in patients with high-normal blood pressure. Weight reduction should be the first line treatment in every obese hypertensive patient. However, patients will often need pharmacological intervention in conjunction with weight loss. (c)2000 by Le Jacq Communications, Inc.