… Background: Various anthropometric tools employed to assess obesity include body mass index (BMI) and waist to hip ratio (WHR) and waist circumference (WC) among others. An increased prevalence of central obesity in Asians calls for evaluation of WHR, WC and BMI as screening tools for obesity among them so as to give a clue about performance of these screening measures in detection of obesity. Study Design: Cross sectional analytical study. Setting: Allied Teaching Hospital Faisalabad. Study Period: December, 2014 to November, 2015. Methods: 377 patients of essential hypertension screened for obesity, using BMI, WHR and WC as screening tools and analyzed and compared their performance in detecting obesity among study subjects. Taking BMI as gold standard, the sensitivity and specificity of WHR and WC was measured along with their positive and negative predictive values. Study subjects were also categorized according to "BMI trigger points for public health consideration" risk categories suggested by WHO for Asian populations. Results: Among 377 study subjects, 239 (63.39%) were categorized as obese by WHR measurements and 254 (67.33%) individuals were labelled as obese by WC measurements compared to 209 by BMI (p-value 0.00 in both cases). This showed a trend towards abdominal pattern of obesity among study subjects. The difference was significant among male as well as female portions of study population, where out of 249 study subjects of male gender, 145 (58.23%) were categorized as obese according to WHR and 156 (62.65%) were labelled as obese according to WC, compared to 125 overweight or obese by BMI (p-value 0.00). Females showed a similar trend with 98 (76.56%) out of 128 labelled as obese by WC and 94 (73.43%) by WHR compared to 84 (65.62%) by BMI. The difference between WHR and BMI in detecting obesity among females was a less significant compared to males. Out of 377 total subjects, 335 fell into increased, high or very high risk categories according to "BMI trigger points for public health consideration". WC showed a sensitivity of 97.13% and specificity of 69.64% whereas WHR showed a sensitivity of 96.65% and specificity of 77.98% when compared as screening tools with BMI as gold standard. Conclusions: WC performed better as a screening tool for obesity when compared with WHR among hypertensive patients. Higher number of obese patients detected by both WC and WHR than BMI showed tendency towards central obesity among study subjects. This difference underscores the relevance of using WC or WHR as measures of obesity especially among Pakistani population.Article Citation: Ghafoor MU, Mahmood-ur-Rehman, Irshad F. Screening tools for obesity; evaluation of waist hip ratio, waist circumference and BMI among hypertensive patients in a tertiary care hospital. Professional Med J 2016;23 (7):844-857.