The purpose of this study was to examine the effects of BMI (Body Mass Index) and WHR (Waist Hip Ratio) on average blood pressure and the prevalence of hypertension in middle-aged and elderly population in rural China. A total of 12955 subjects including 6276 males and 6688 females over 40 years of age were surveyed. Height, weight, waist circumference, hip circumference and blood pressure were measured. The association of BMI and WHR on average blood pressure levels and prevalence of hypertension were analyzed by dividing BMI and WHR into tertiles. The average blood pressure levels and the prevalence of hypertension in males and females increased significantly with the increase of BMI or WHR (P < 0.01), as well as with the increase of both of them (P < 0.01). The average blood pressure and the prevalence of hypertension stopped increasing when WHR was > or = 0.76, suggesting that WHR > or = 0.80 could be used as a cut-off value for the prediction of hypertension risk for both males and females. Therefore hypertension could be effectively prevented and controlled by controlling BMI and WHR.