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Background Cytomegalovirus (CMV) is a chronic infection that is widely distributed in the population. CMV infects a range of tissues, including endothelium, and viral replication is suppressed by the host immune system. Infection is associated with increased risk of mortality from vascular disease in older people but the mechanisms behind this have not been determined. Aim We investigated the association between CMV infection and cardiovascular phenotype in a cohort of healthy elderly donors Design CMV serostatus and cardiovascular parameters were determined in the Lothian Birth cohort which comprises 1091 individuals aged 70 years in whom many environmental, biochemical and radiological correlates of vascular function have been determined. Methods CMV serostatus was determined by ELISA and correlated with a range of biochemical and phenotypic measures. Results 65% of participants were CMV seropositive which indicates chronic infection. The mean sitting systolic blood pressure was 149·2 mmHg in CMV seropositive individuals compared with 146·2 mmHg in CMV seronegative subjects (sd 18.7 vs 19.7; p<0.017). This association between CMV infection and systolic blood pressure was not attenuated after adjustment for a wide range of biological and socio-economic factors. Conclusions These data show that CMV infection is associated with an increase in systolic blood pressure in individuals at age 70 years. The magnitude is comparable to environmental variables such as obesity, diabetes or high salt intake. This is the first evidence to show that a chronic infection may be an important determinant of blood pressure and could have significant implications for the future management of hypertension.