Objective: To evaluate the association between aortic pulse wave velocity (PWV) and all-cause mortality in a low to moderate risk population.

Methods: 1952 subjects (1319 men, 633 women), who benefited from a standard health check-up at the IPC center (Paris) in 1992/1993, had also an aortic PWV measurement. Mean follow-up was 13.4 ± 1.2 years, and 61 men (4.6%) and 18 women (2.8%) died. The population was divided in two groups of age (<60 and >=60 years). Cox regression model, including age, gender, tobacco, cholesterol, heart rate, blood pressure, glycaemia, assessed the risk of all-cause mortality for an increase of 1 m/sec of PWV (Hazard Ratio (HR), 95% CI).

Results: Age was 45.0±9.3 years in young and 64.5±3.8 years in old subjects. In overall population, PWV was 9.6±2.2 m/sec, and increased with age: 9.2±2.0 m/sec in youngest and 11.0±2.2 m/sec in oldest. After adjustments, excepted on BP, HR for all-cause mortality risk associated with PWV was 1.12 (1.03–1.22), but after adjustment on all variables, relationship was no longer significant: HR=1.08 (0.98–1.18). Before 60 years, after adjustments, PWV-related risk was 1.09 (0.95–1.24), (NS), but it reached 1.22 (1.08–1.38), p<0.02, in patients >60 years.

Conclusion: In a low to moderate risk population, aortic PWV was significantly and independently associated with all-cause mortality only among subjects after 60 years. In such population, the direct impact of BP on aortic stiffness overcomes the intrinsic stiffness alterations which are linked to all-cause mortality, at least in young, low risk, subjects.