Objective: Carotid – femoral aortic stiffness (PWV) and pressure wave reflections (AI), both markers of cardiovascular mortality, are considered to increase in parallel. A disassociation between PWV and AI has been described. In a cohort (PROTEGER study) of old population (85.4±0.5) has been previously observed that neither PWV nor AI, were predictors of mortality. The aim of the present analysis was to investigate the association between PWV and AI as well as their combined effect on mortality.

Methods: Pulse wave analysis was applied in 259 subjects for the assessment of PWV and AI. The population was divided and analyzed according to tertiles of PWV and AI.

Results: Eighty-seven subjects died during the follow up (2 years). No association was found between PWV and AI. The subjects with combined high PWV (3^rd tertile) and high AI (2^nd and 3^rd tertiles) [group a] had significantly higher mortality compared to the rest of the population [group b] (27/56: 48.6% vs 61/203: 30.1%, p<0.05, Kaplan Mayer log-rank p=0.003). No significant differences were found between group a and b regarding cardiovascular (CV) risk factors. Cox regression analysis showed that group a had higher mortality independently from age, gender, cardiovascular (CV) history and classical CV risk factors.

Conclusion: PWV and AI were not independent predictors of mortality. However, those subjects with combined increase of PWV and AI have higher mortality suggesting that: (i) the effect of PWV is more prominent in the presence of increased AI and (ii) that the disassociation between PWV and AI may be related to reduced mortality.