Adiponectin, which is secreted specifically by adipose tissue, has been shown to act as an anti-atherosclerotic protein. Several studies have shown that adiponectin levels are lower in individuals with obesity, diabetes and cardiovascular disease. The present study investigated relationships between serum adiponectin levels and body mass index (BMI), waist-to-hip ratio (WHR), blood pressure (BP) and lipid profiles in 300 middle-aged Korean women (mean age 50.6 +/- 6.2; BMI 25.78 +/- 3.68 kg/m(2)). The serum adiponectin level was positively associated with high density lipoprotein (HDL)-cholesterol (r = 0.29) and negatively associated with BMI, WHR, percent body fat, triglyceride (TG), systolic BP, and diastolic BP. Multivariate logistic regression analysis revealed that increasing concentrations of adiponectin were associated with lower risk of hypertension. In overall odds ratios (95% CIs) for hypertension, those in the second, third, and fourth (versus the first) quartile of adiponectin after adjustment for age were 0.59 (0.297-1.185), 0.47 (0.236 - 0.938), and 0.32 (0.16 - 0.648), respectively. Regardless of BMI, WHR and percent body fat, higher adiponectin was independently associated with a lower risk of hypertension. These findings suggest that the serum adiponectin level is decreased with atherogenic lipid phenotype including hypertriglyceridemia and low HDL-cholesterol. Furthermore, low serum adiponectin concentration may be an independent risk factor for hypertension in middle-aged Korean women.