The authors considered four indexes to better assess one of the most important risk factors of cardiovascular disease: high blood pressure. These indexes are: systolic pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP difference between systolic and diastolic pressure) and mean pressure (MBP). Some studies have shown that the SBP is a stronger predictor for cardiovascular disease than the DBP (Am J Cardiol 1971, 27:335-346; Hypertension 1999, 34:386-387; Hypertension 1999, 34:381-385; Am J Cardiol 2000, 85:251-255), and that the PP is an important index for coronary artery disease especially in older people (Circulation 1999, 100:354-360; Hypertension 1998, 32:560-564; Hypertension 1997; 30 :1410-1415). The Japan Arteriosclerosis Longitudinal Study Group has conducted a meta-analysis of 16 studies in Japan. Were enrolled a total of 48,224 persons (21,061 men and 27,163 women) with an age between 40 and 89 years. During the period of follow up of 8.4 years were registered 1231 strokes and 220 myocardial infarctions. All four indexes were found to be statistically related to the risk of stroke. The risk of stroke was more closely linked to MBP and SBP in both sexes, and most weakly linked to PP. Both types of stroke, ischemic and hemorrhagic, were closely linked to MBP and SBP in both sexes. In men and women aged between 70 and 89 years, the SBP and MBP showed a closer relationship with the risk of stroke. The risk of myocardial infarction was more closely related to SBP or MBP in both sexes. For each endpoint (incidence of stroke and/or myocardial infarction) in all ages and both sexes PP was not the strongest predictor. The conclusions of this work can be summarized as follows: 1) the incidence of long-term risk of stroke and myocardial infarction associated with hypertension in East Asian populations should be based mainly on SBP; 2)MBP can also be an important predictive factor, but the PP is less important predictor for the risk of cardiovascular disease. The authors correctly underline the limits of this work: it is a meta-analysis of 16 different studies, the method of measurement of BP has not been well standardized and the data of possible antihypertensive treatment at baseline was not always accurate.