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Objective To investigate the relationships of blood pressure with carbohydrate metabolism, sympathetic activity and cortisol at different levels of body mass index in middle-aged men.Methods Cross-sectional data concerning men studied in the Paris Prospective Study I were analysed. The cohort included 6424 subjects aged 40-53 years at entry, who were not being treated for hypertension or diabetes and had no overt heart disease. The parameters analysed were glucose, insulin and free fatty acids levels, all assessed during fasting by the subject and 2h after a 75 g glucose load, resting heart rate and morning plasma cortisol levelsResults Subjects with systolic blood pressure > 160mmHg had significantly higher glucose concentrations at any body mass index level whereas the difference in insulin levels between the subjects with and without high systolic blood pressure increased with body mass index. Heart rate, free fatty acids level and cortisol level were significantly higher in men with high systolic blood pressure. However, these parameters showed significant decreasing trends with body mass index. In normotensives, no such trends were observed. When analysing data according to diastolic blood pressure, the limit being 95mmHg, similar results were obtained for glucose and insulin levels, but no trend in heart rate, free fatty acids level and cortisol level with the body mass index level was statistically significant.Conclusions Mean glucose concentrations are higher in hypertensive men at all body mass index levels, whereas relative hyperinsulinaemia is present only in the more corpulent hypertensives. Heart rate, free fatty acids level and morning plasma cortisol level are elevated in hypertensive subjects at any body mass index level, but particularly in the lean ones with high systolic blood pressure.