OBJECTIVE:Pulse pressure (PP), is a simple measure of arterial stiffness. Several studies have shown that PP increases the risk of cardiovascular (CV) events but they were limited to clinic measure, mostly performed on individuals with high CV risk. Furthermore few studies reported PP-related risk of morbidity and mortality separately for genders. DESIGN AND METHOD:3200 subjects, stratified for sex and decades of ages, were randomly selected to be representative of the general population of Monza (Northern Italy). In each subject we performed the following mesurements1) Clinic (C) Systolic (S) Blood Pressure (BP) and Diastolic (D) BP (sphygmomanometer), 2) Home SBP and DBP (Philips HP 5331), 3) Ambulatory (24 h) SBP and DBP (Spacelabs 90207), 4) Body Mass Index (BMI), 5) Blood Glucose and Serum Cholesterol. Each subject was followed for 12 years, during which all deaths were collected and classified by ICD-X codes as being a CV (ICD-X I-0 to I-99) or non CV death. Non-fatal CV events were identified by hospital diagnosis also using ICD-X codes and validated on the hospital clinical records. RESULTS:The complete data set was obtained in 2045 subjects. PP was calculated as difference between SBP and DBP. Office, home and 24 h blood pressures were significantly higher in individuals who experienced a CV event or died during follow-up. Clinic, 24 h and Daytime PP were independent predictors of CV events after adjustment for main demographic and clinical parameters in the whole study population (HR 1.24, CI 1.03–1.49; HR 1.17, CI 1.01–1.36; HR 1.2, CI 1.03–1.39, respectively; p < 0.05 for all). Nighttime PP was an additional independent predictor in men (HR 1.23, CI 1.03–1.47, p < 0.05). None of measured PP (Clinic, Home, 24 h, Day- and Nighttime) was predictor of CV events in women. None of calculated PP was predictor of all-cause mortality in general population and in both genders. CONCLUSIONS:Clinic and 24 h, but not home, PP represent a predictor of CV events in general population and in its male fraction. In females PP does not increase risk of CV events. All-cause death is not predicted by any of the PP measured.