The objective of this study was to study the relative contribution of body mass index (BMI) and cardiorespiratory fitness on systolic blood pressure. For that purpose, 35,061 patients from the Cooper Center Longitudinal Study were evaluated. The analysis revealed that individuals who were in the lowest BMI quartile had a significantly lower mean systolic blood pressure compared with individuals in the highest BMI quartile (116±14 vs. 126±14 mm Hg, p<0.001). On the other hand, higher levels of cardiorespiratory fitness were associated with lower mean systolic blood pressure. However, when BMI and cardiorespiratory fitness were assessed simultaneously, systolic blood pressure was mostly predicted by BMI. The results also showed that the impact of fitness on systolic blood pressure was most apparent in individuals who were normal weight. Therefore, these findings suggest that hypertension prevention should focus primarily on weight control before expecting an impact of cardiorespiratory fitness on blood pressure.
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