It is established that obesity is an important risk factor for hypertension
, but there is little information on this relationship among highly educate
d black women. We assessed the relationship of body mass index (weight (kg)
/height(2) (m)) to prevalent hypertension among US black women who had comp
leted college, and among less educated women as well. The data were collect
ed in 1995 in the Black Women's Health Study: 64530 African-American women
aged 21 to 69 years enrolled by completing mailed health questionnaires; 44
% of the participants had completed college. We compared the 9394 participa
nts who reported a diagnosis of hypertension treated with a diuretic or ant
ihypertensive drug (cases) with 9259 participants of similar ages who did n
ot have hypertension (controls). Multivariate odds ratios were estimated by
logistic regression. The odds ratio for treated hypertension increased wit
h increasing body mass index at every educational level. Among college-educ
ated women, the odds ratio for hypertension was 2.7 for overweight women (i
ndex 27.3-32.3) and 4.9 for severely overweight women (index greater than o
r equal to 32.3), relative to women with a body mass index <22.8. The preva
lences of obesity and hypertension were high among the college-educated wom
en, although not as high as among women with fewer years of education. Abou
t a quarter of the difference in the prevalence of hypertension across educ
ational levels was explained by the difference in the proportions who were
overweight or severely overweight. These results document a high prevalence
of obesity and hypertension, and a strong association of obesity with hype
rtension, among highly educated US black women.