Data from the First Health and Nutrition Examination Survey (HANES), 1971-1974, were used to examine the relationship between blood pressure and the distribution of subcutaneous body fat in 5506 survey participants, ages 30-59. Triceps and subscapular skinfolds were used as approximations of peripheral and centrally located body fat. The effects of race, sex and age on the obesity-blood pressure relationship were analyzed. Subscapular skinfold was the better predictor of both systolic and diastolic blood pressure in each race-sex group, sharing all of the association of triceps with blood pressure and having significant predictive power unshared by triceps. The slopes of regression of subscapular skinfolds with systolic blood pressure for each race-sex group were not significantly different. A 1 mm increase in skinfold thickness increased the predicted mean systolic blood pressure by 0.63 +/- 0.03 mmHg (F = 519). Mean diastolic blood pressure rose 0.43 +/- 0.02 mmHg per unit increase of skinfold in whites (F = 549), and 0.14 +/- 0.04 mmHg less in blacks (F = 13), indicating a significant racial difference. Age and subscapular skinfold contributed independently to the variability in blood pressure in each race-sex group. These results demonstrate that the blood pressure of middle-aged Americans is more directly associated with centrally deposited body fat. This finding is true across race and sex groups, and is independent of age.

AN ASSOCIATION between adult obesity, cardiovascular renal disease, and diabetes has been demonstrated from life insurance data and from various prospective field studies (1-3). However, the nature of this relationship has not been defined. Despite the evidence relating childhood obesity to adult obesity, little information is available on the role of childhood obesity in the morbidity or mortality of adults.We investigated the relationship of childhood weight status to adult levels of selected physiological variables and to increased morbidity from cardiovascular renal disease and diabetes.The study population was located in Hagerstown, Md., an area which has been followed as a population laboratory by the Public Health Service since the 1920's (4). We selected 1,963 white males who had attended elementary schools in Hagerstown between 1923 and 1928, who were in the age group 9-13 years at that time, and whose height and weight measurements were available. Childhood weight status was determined by using relative weight defined as the deviation of actual weight for given sex, age, and height from average weight values, times 100, obtained from the Baldwin-Wood height-weight tables (5). Adult FollowupTo locate the study population a systematic search was made between 1961 and 1963 of available records, which included the city directory, telephone

Overweight children usually become overweight adults9 according to a study, spanning 20 years, of 200 residents of Hagerstown, Md.

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