Aortic pulse wave velocity (PWV) is a significant and independent predictor of cardiovascular disease in hypertensive subjects and in patients with end-stage renal disease, but there have been few studies on PWV in Chinese patients with essential hypertension. In this cross-sectional study, we investigated 3,156 consecutive patients (mean age: 53.7 +/- 11.58 years) of the Hypertension Division of Ruijin Hospital in Shanghai. Together with sphygmomanometric blood pressure measurements, aortic PWV was measured using a validated automatic device. PWV in patients with pulse pressure (PP) > or = 60 mmHg was significantly greater than that in patients with PP < 60 mmHg (p < 0.01). PP and PWV were positively related to age (PP: r = 0.396, p = 0.001; PWV: r = 0.531, p = 0.001). After adjustment by age and heart rate, PWV was still closely related to PP (r = 0.249, p = 0.001). At any given systolic blood pressure (SBP), PWV significantly decreased with the increase of diastolic blood pressure (DBP), whereas at any given DBP there was a significant increase of PWV with the increase of SBP. In conclusion, PWV was the major determinant of PP, and was highest in Chinese patients with isolated systolic hypertension, followed by those with systolic and diastolic hypertension, isolated diastolic hypertension, and normal blood pressure.