We evaluated the association between pulse pressure (PP) and cardiovascular risk factors in a screened cohort. Individuals who were receiving medications for hypertension or heart disease, who had no ECG record, or who had a record of arrhythmia were excluded. In total, 8,508 subjects (5,299 men and 3,209 women; age range, 18 to 89 years) were studied. Subjects were divided into four PP classes: PP.1 (PP 40 mmHg, n 2,127), PP.2 (40 PP 44 mmHg, n 2,127), PP.3 (44 PP 50 mmHg, n 2,127) and PP.4 (50 mmHg PP, n 2,127). Multiple regression analysis was used for evaluating the association between PP and cardiovascular risk factor or lifestyle. In men, the regression coefficient was 0.27 for age, 2.50 for diabetes mellitus, 0.33 for uric acid, 0.20 for body mass index, 0.07 for heart rate, 0.83 for current smoking habit and 1.23 for habitual drinking. In women, the regression coefficient was 0.37 for age, 4.09 for diabetes mellitus, 0.42 for body mass index, 0.14 for heart rate, and 0.84 for habitual exercise. In both men and women, PP was significantly increased in association with an increase in the number of risk factors (diabetes mellitus, obesity, current drinking status, heart rate, and hyperuricemia). In conclusion, higher PP was associated with cardiovascular risk factors. These associations were similar in both men and women. older subjects, is an independent predictor of coronary heart disease (3-7). In their prospective population-based study, the Framingham group found that cardiovascular mortality, and particularly coronary mortality, was independently related with initial SBP, DBP, and PP, and that PP showed the strongest association (8). Therefore, the goal of the present study was to evaluate the association of PP with classical cardiovascular risk factors in a screened cohort in Okinawa, Japan.