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Truncal obesity judged by increased waist-hip ratio (WHR) is an important risk factor for atherosclerosis. One of the mechanisms postulated by which truncal obesity increases coronary risk is high blood pressure (BP). Studies of correlation of WHR with systolic and diastolic BP have shown conflicting results. A study on 443 persons (250 males, 193 females) for WHR measurement during a comprehensive cardiovascular survey in an urban population of Rajasthan was undertaken. The mean WHR in males was 0.90 +/- 0.07 and in females 0.87 +/- 0.08. The median value was 0.91 in males and 0.88 in females. Correlational analysis of WHR with anthropometric and clinical parameters showed that in males there was a positive relationship of WHR with weight (r = 0.11), body mass index (r = 0.13) and systolic (r = 0.11) and diastolic BP (r = 0.11) but not with age and height. In females no significant relationship was seen with these variables. When classified according to the US Fifth Joint National Committee (JNC-V) recommendations for diagnosis of truncal obesity (WHR males > 0.95, females > 0.85) it was seen in 42 (17%) males and 131 (68%) females. Sub-analysis of these two groups showed that mean values of systolic and diastolic BP were not significantly different in truncally obese subjects. However, stratified analysis after classifying WHR in four groups (WHR < 0.85, 0.85-0.89, 0.90-0.95 and > 0.95) showed that in males there was a significantly rising trend of weight, body mass index, systolic and diastolic BP with increasing WHR. WHR of > or = 0.85 was associated with higher systolic and diastolic BP.