Obesity, Hypertension, and Cardiovascular Disease

To the Editor.— The article entitled Does Obesity Protect Hypertensives Against Cardiovascular Disease? 1 in the Dec 5,1986, issue of JAMA purports to show results inconsistent with previous studies that suggested differences in outcome between obese and non-obese hypertensives. Table 2 in this article clearly shows no relationship between obesity and either cardiovascular deaths or coronary heart disease deaths among the normotensives, and a possible weak relationship among hypertensives, with coronary heart disease and total cardiovascular deaths primarily limited to stratum 1 only. Missing from Table 2 is the group Other cardiovascular disease found by subtracting coronary heartdisease deaths from the total cardiovascular disease deaths. The Table is a revised version of Table 2 from the original article. There is a very strong inverse relationship between obesity and other cardiovascular diseases, in terms of both total disease and deaths, among the hypertensives. Those hypertensives in the lowest weight