Despite the overwhelming evidence that weight reduction lowers blood pressure (BP), the magnitude of the effects and whether obese hypertensive with higher or lower BP andbody weight mightbenefit in a different way from weight lossis still unclear. Four hundred and ninety obese hypertensive patients (32.6%, class I, 41.2 % class II and 26.1% class III obesity) entered a 3-month lifestyle intervention. The intervention induced a significant reduction in weight (-4.9 %,-4.8 kg), SBP (-6.3%, - 9.3 mmHg) and DBP (-4.3%, -3.9 mmHg). In patients who lost >10% of weight, DBP decrease was significantly greaterthan in those who lost less weight. The SBP and DBP reduction was similar in the 3 classes of obesity and was stronger in patients with uncontrolled hypertension:-23.6 mmHg (95% CI, -26.3 to -20.8) of SBP and -9. 2 mmHg (95% CI,-11.2 to -7.2) of DBP. SBP and DBP changes were strongly correlated with pre-intervention BP levels (r – 0.623 for SBP and r – 0.613, for DBP, p< 0.0001 for both). SBP was very slightly associated with weight changes (r 0.116, p<0.01).BP changes were unaffected by age, sex, presence of metabolic alterations, family history of obesity, cardiovascular diseases and diabetes and by changes in waist circumference, fat mass and metabolic variables. Baseline BP values explained 38.8% of variance of SBP changes and 37.4% of DBP changes, whereas weight changes explained only 1.7% of SBP changes. In conclusion, in obese hypertensive patients short-term lifestyle changes lead to a clinically significant BP reductionthat is independent of degree of obesity, age, sex and concomitance of metabolic alterations. The efficacy of intervention is greater in patients with higher BP levels and has a nonlinear relation with weight changes.