Abstract-The goal of the present study was to evaluate mean values and heritability estimates of 3 global and 11 regional obesity measures in siblings with (HPT, nϭ209) or without (non-HPT, nϭ91) early-onset (age Յ55 years) hypertension who originated from the same families. Sixty-one sibships, each having at least 2 HPT siblings, were selected from a French-Canadian population with a known founder effect. Comparison of the mean values showed that HPT siblings are more obese than non-HPT siblings and that the body fat of HPT siblings is more centrally distributed. Significant differences were observed in all global obesity measures (Pϭ0.009 to 0.0001). Among the regional measures, the most prominent differences were seen in waist circumference (Pϭ0.00002), waist/hip ratio (Pϭ0.0001), and suprailiac skinfold (Pϭ0.00008). Comparison of the heritability estimates derived from sibling/sibling correlations (FCOR program, SAGE) suggested that genetic factors play a greater role in HPT (nϭ357) than in non-HPT (nϭ93) sib-pairs in determining most obesity measures. Similar to the mean values, these differences were most apparent in global and upper-body measures, with heritabilities ranging from 40% to 70% (Pϭ0.05 to 0.0006) in HPT siblings and from 0% to 32% (PϭNS) in non-HPT siblings. In summary, the present results suggest that HPT and non-HPT siblings drawn from the same families differ by the degree and distribution of body fat accumulation and that this difference is determined, at least in part, by genetic factors cosegregating with hypertension. This, in turn, suggests that a genetic link exists between obesity and hypertension in these families. Key Words: obesity Ⅲ hypertension, essential Ⅲ genetics Ⅲ siblings O besity is a major risk factor for the development of essential hypertension. A positive relationship between body weight and blood pressure has been demonstrated in both sexes and in people of different ethnic backgrounds. [1][2][3][4][5] Studies suggest that not only the degree but also the distribution of accumulated body fat is an important risk factor for the development of hypertension. 6 It has long been recognized that the prevalence of hypertension is higher in individuals with upper-body obesity than in individuals with lower-body obesity. 7,8 More recently, this difference has been related to the increased quantity of intra-abdominal visceral fat 9 that is frequently found in individuals with upper-body obesity. 10 Mechanisms of the relationship between visceral obesity and hypertension are not well understood. It has been proposed that, because visceral fat is characterized by a relatively high lipid turnover, 11 its accumulation may result in higher levels of free fatty acids in the portal circulation. This, in turn, may contribute to the development of hypertension via a number of disturbances, including the enhancement of lipid synthesis, gluconeogenesis, insulin resistance, and aldosterone production. [12][13][14] Genes play a significant role in the development of both obesity and hype...