Truncal obesity has been identified as a risk factor for coronary heart disease (CHD). We studied 399 males for waist hip ratio (WHR) measurement during a comprehensive cardiovascular survey in a rural population of Rajasthan. The WHR measurements were correlated with coronary risk factors and CHD prevalence. The mean WHR in the study population was 0.88 +/- 0.11. The median value was 0.88 with a range of 0.49 to 1.59. Multiple regression analysis showed a significant positive relationship of WHR with height (b = 0.77, p = 0.02), weight (b = 1.48, p = 0.02), body mass index (b = 1.44, p = 0.01) and systolic (b = 0.12, p = 0.05) and diastolic blood pressure (b = 0.13, p = 0.03) but not with age, educational level, total LDL- or HDL- cholesterol and triglycerides. The median value of 0.88 was taken to classify the study population for risk factor analysis. There were 200 males with WHR < or = 0.88 (Group A) and 199 males with WHR > or = 0.88 (Group B). Group B men had significantly higher body-weight and body-mass index and there was a trend towards lower serum HDL cholesterol and higher triglyceride levels in this group which was not statistically significant. The prevalence of hypertension was similar in the two groups. The prevalence of coronary heart disease was significantly higher in Group B.