To determine the prevalence of coronary heart disease (CHD) and coronary risk factors in an urban Indian population, we studied a random sample of population of Jaipur. A physician-administered questionnaire, physical examination and a 12-lead electrocardiogram was performed on 2,212 adults of > or = 20 years of age (males 1,415, females 797). CHD was diagnosed on the basis of past documentation, response to WHO-Rose questionnaire or changes in the electrocardiogram. The overall prevalence of CHD was 7.6 percent (168 cases). The prevalence rate was 6.0 percent (84) in males and 10.4 percent (84) in females with an age-related increase in prevalence ('p' for trend < 0.001). When diagnosed on the basis of electrocardiographic changes alone (Q, ST or T wave), the prevalence was 5.2 percent (116), with 3.5 percent in males and 8.4 percent in females. CHD was silent in 57 percent males and 79 percent females. Coronary risk factors were observed in a significant proportion: smoking in 32 percent (males 39 percent, females 19 percent), hypertension (> or = 140/90 mm Hg) in 31 percent (males 30 percent, females 34 percent-JNC-V) and > or = 160/95 mm Hg in 11 percent (males 10 percent, females 12 percent; WHO classification), diabetes in 1 percent and sedentary habits in 71 percent. Additional risk factors were generalised obesity (body-mass index > or = 27 Kg/m2) in 11 percent and truncal obesity (waist-hip ratio > 0.95) in 17 percent males and 13 percent females. Significant association of CHD prevalence were seen with age, sedentary habits and presence of hypertension in both males and females, and in addition with smoking in males.