This study compared three different measures of central adiposity: waist-to-hip ratio (WHR), waist-to-height ratio (WSHT), and waist circumference with cardiovascular risk factors, including serum lipoproteins and blood pressure in overweight pre- (n = 115) and postmenopausal (n = 46) women. Premenopausal women had a mean age of 35.6 +/- 6.79 y and a mean body mass index (BMI; in kg/m2) of 37.08 +/- 6.01. Postmenopausal women had a mean age of 52.5 +/- 8.19 y and a mean BMI of 38.75 +/- 6.9. Although several correlations between central adiposity and serum lipoproteins and blood pressure were significant, they were unaffected by menopausal status. There were also no significant differences among the three measures of central adiposity in relation to cardiovascular risk factors within premenopausal and postmenopausal groups. An analysis of covariance controlling for BMI showed that after stratifying WSHT into tertiles, a significant interaction of WSHT group by menopausal status was found for systolic blood pressure (SBP) (P = 0.019). Postmenopausal women had a significantly greater SBP than premenopausal women in the lowest and highest tertiles (P = 0.001); however, this pattern was not shown in the middle WSHT tertile. The relation between central adiposity and cardiovascular risk factors appears to be unchanged after menopause, except when WSHT is used to indicate SBP. Because increased central adiposity may also indicate an increase in cardiovascular risk factors, measurements of central adiposity can be used to supplement the routine clinical evaluation of cardiovascular risk factors in both pre- and postmenopausal overweight women.