Abstract-The purpose of the present study was to determine the relationship between body mass index (BMI) and parameters derived from 24-hour ambulatory blood pressure monitoring including mean 24-hour daytime and nighttime systolic and diastolic blood pressures, 24-hour daytime and nighttime pulse pressure, mean 24-hour daytime and nighttime heart rate, dipping and nondipping status. 3216 outpatient subjects who visited our hypertension center and were never treated with antihypertensive medication underwent 24-hour blood pressure monitoring. BMI was significantly correlated with clinic systolic and diastolic blood pressures. Significant correlations were also found between BMI and mean 24-hour daytime and nighttime systolic blood pressure, 24-hour daytime and nighttime pulse pressure, and mean 24-hour daytime and nighttime heart rate. In multivariate regression analysis, clinic systolic, diastolic blood pressure, mean 24-hour systolic blood pressure, 24-hour pulse pressure, and high-density lipoprotein were independently correlated with BMI. The incidence of white coat hypertension was higher in overweight and obese patients than in normal weight subjects. Confirmed ambulatory blood pressure hypertension was also found to be higher in overweight and obese individuals compared with normal weight subjects. Our data also highlight the higher incidence of nondipping status in obesity. These findings suggest that obese patients had increased ambulatory blood pressure parameters and altered circadian blood pressure rhythm with increased prevalence of nondipping status. Key Words: blood pressure monitoring, ambulatory Ⅲ body mass index Ⅲ hypertension Ⅲ obesity T he increasing prevalence of obesity in industrialized countries is an alarming epidemic. Epidemiological studies clearly demonstrate a correlation between body weight and blood pressure in obese populations. In the Framingham Study, 70% of the new cases of essential hypertension were related to excess body fat. 1 Population studies have shown that office blood pressure closely correlates with body mass index (BMI) and other anthropometric indices of obesity such as waist-to-hip ratio. 2 Experimental studies in animals have also shown that excess weight gain caused by a chronic high-fat diet almost invariably raises blood pressure. [3][4][5] Considerable evidence suggests that excess weight gain is related to human essential hypertension. Currently, 30% to 35% of adults in the United States are obese, and Ͼ30% are overweight. 6 -10 In some groups, such as black women older than age 50, the prevalence of obesity may be as high as 70% to 80%, coinciding with a rate of hypertension of Ͼ70%. 11 Initially reserved for research purposes, ambulatory blood pressure monitoring has gradually become a widely used clinical tool for diagnostic purposes and for assessment of treatment efficacy. Evidence is available that 24-hour day or nighttime average blood pressure values correlate with subclinical organ damage more closely than office values. 12 Evidence is also availa...

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