Although mitral annular velocity assessed by tissue Doppler echocardiography has been established as a parameter of left ventricular (LV) diastolic function, aortic annular velocity has never been investigated as a parameter of cardiovascular function. We investigated whether aortic annular velocity can be measured using the same tissue Doppler echocardiographic method that is used for measuring mitral annular velocity, as well as the correlation between the aortic annular velocity thus measured and arterial stiffness that was assessed by the cardio-ankle vascular index (CAVI). Sixty-three patients (69 +/- 13 years) with hypertension, diabetes, or dyslipidemia, who had no overt heart disease, were enrolled. The mitral and aortic annular velocities were measured at the mitral and aortic annuluses, respectively, using tissue Doppler echocardiography. Aortic annular velocity was successfully obtained in all patients. The correlation between the peak early diastolic aortic annular velocity (r = -0.803, p < 0.001) and CAVI as an index of arterial stiffness was greater than that of the peak early diastolic mitral velocity and CAVI (r = -0.649, p < 0.001). Stepwise regression analysis showed that the age (beta coefficient = 0.488, p = 0.002) and the peak early diastolic aortic annular velocity (beta coefficient = -0.405, p = 0.008) were independent determinants of the CAVI. The strong inter-relationship was found between left ventricular diastolic function assessed by the aortic annular velocity and arterial stiffness assessed by CAVI. In conclusion, the aortic annular velocity may be helpful for assessing arterial stiffness in patients with cardiovascular risk factors.