Aim To investigate the associations of body mass index(BMI), waist circumference(WC), and neck circumference(NC) with hypertension in elderly men and women. Methods The study performed a cross-sectional survey by cluster sampling among the elderly of 65 years or older in 11 residential committees of Puxing Community, Pudong New District, Shanghai. The Excel software was used to construct a database, and the SPSS statistical software(Version 17.0) for univariate and multivariate analysis. It also performed analysis on blood pressure across the quartile distributions of neck circumference in women. Results A total of 2 092 subjects included 971 men(46.4%) and 1 121 women(53.6%). BMI, waist circumference and neck circumference were higher in hypertensive subjects than normotensive subjects both men and women(P<0.1). The proportions of general obesity, abdominal obesity and greater neck circumference were significantly higher in hypertensive subjects than in normotensive subjects(P<0.1). In multivariate Logistic regression analysis with adjustment for other covariables, all three obesity indices were associated with hypertension. With mutually adjustment for other obesity indices, only greater neck circumference was significantly associated with hypertension in elderly women(OR 1.4,5%CI 1.03～2.01, P=0.032) for additional adjustment with BMI, and(OR 1.6,5%CI 1.12～2.18, P=0.9) for additional adjustment with waist circumference. The level of systolic and diastolic blood pressures and the prevalence of hypertension increased with the quartile distributions of neck circumference in elderly women. The risk of hypertension was significantly higher in those with the neck circumference ≥36 cm compared with those whose neck circumference <32.5 cm(OR 2.1,5%CI 1.51～3.24, P< 0.1). ConclusionsIn this elderly population, all three obesity indices was associated with hypertension. The neck circumference was associated with hypertension independently of other two obesity indices in elderly women.