The relationship between relative fatness and subcutaneous fat distribution was examined in a sample of 124 hypertensive and 402 normotensive individuals. We explored the interactions between relative weight, adiposity, and preferred sites of fat accumulation in relation to disease risk, as measured by hypertensive status, blood pressure levels, and blood lipid concentrations (total cholesterol, triglyceride and HDL cholesterol). The participants were classified into quintiles of age-adjusted weight, body mass index (BMI), waist-to-hip ratio (WHR), subscapular skinfold, and a relative fat pattern index (RFPI). The mean values for blood pressure and blood lipids at each quintile of the anthropometric indices were compared by sex and hypertensive status. In the normotensive men and women, blood pressure and blood lipids levels were strongly associated with all indices of body size and adiposity. However, among hypertensive men and women the associations between blood pressure and blood lipids with anthropometric indices were significantly different across quintiles of distribution for the different indices. Our study suggests that in medicated hypertensives blood pressure and blood lipid levels can be present in the very lean and unrelated to body size, or they can be strongly associated with ponderosity and fat distribution. The difference in blood pressure and blood lipid levels from the second to the third quintiles on any one of the anthropometric indices considered is greater that the difference between the top quintiles.