In subjects with impaired glucose tolerance (IGT) who participated in the Indian Diabetes Prevention Programme (IDPP), abnormalities related to body mass index, waist circumference (WC), blood pressure (BP), lipid profile and electrocardiography were analysed (at baseline and third-year follow-up) in control, lifestyle modification (LSM), metformin (MET) and LSM + MET groups. At baseline, elevated levels of low-density lipoprotein cholesterol (LDL-C) showed the highest (78.6%) and total cholesterol (TC) showed the lowest (42%) prevalence. At follow-up, prevalence of hypertension (BP > or = 130/> or = 85 mmHg) had increased significantly in all groups. Cardiovascular abnormalities were lower in intervention groups, with the lowest rates in the MET group (p=0.013 vs. control); the LDL-C level decreased in intervention groups. In this programme, Asian Indian IGT subjects were observed to have a high prevalence of cardiovascular risk factors. LSM and MET had beneficial effects on the atherogenic phenotype of lipids but had no influence on blood pressure.