Fat-cell weight, fat-cell number, and hemodynamic indexes were determined in 25 obese men with sustained elevation of BP. Fat-cell weight (and not fat-cell number) was positively correlated with overweight (r = .51) and mean arterial pressure (MAP) (r = .57) in basal conditions. After body weight reduction, BP decreased significantly through a decrease in cardiac index due to a predominant decrease in heart rate. Simultaneously, fat-cell weight decreased significantly. The ratio between the change in BP and the change in body weight, ie, the ability to decrease pressure per unit weight loss, was positively related to the level of initial BP (r = .80) and reached a plateau above 120 mm Hg of the initial MAP. We suggest that, in patients with obesity and hypertension, high BP is associated with hypertrophic obesity, and after body weight reduction, the simultaneous decrease in BP, heart rate, and fat-cell weight could be mediated by neurogenic mechanisms.