Subclinical vascular damage (SVD) predicts cardiovascular events independently of traditional risk factors in apparently healthy subjects. But information on coexistence and additive prognostic importance in different age and groups are lacking. In 2082 apparently healthy subjects aged 41, 51, 61 and 71 years we estimated cardiovascular risk using SCORE, performed ultrasound of the carotid arteries and measured urine albumin/creatinine ratio (UACR) and pulse wave velocity (PWV) in 1993. The composite endpoint (CEP) of cardiovascular death, non-fatal myocardial infarction and stroke, and hospitalization for ischemic heart disease was recorded until 2006. Between the four age groups and the four SCORE risk groups, the prevalence of hyperalbuminuria (above 90 percentile), atherosclerotic plaques and elevated PWV increased. The prevalence of subjects with one or more SVD increased between the four age groups as well as the four risk groups. Increasing numbers of markers for SVD (0, 1, 2 or 3) was associated with higher incidence of CEP in the three youngest age groups (41+51 years: 4.7, 9.4, 20.8, 50%; 61 years: 7.7, 15.3, 25.9, 35.7%, both P<0.001; 71 years: 21.2, 21.5, 27.9, 43.3%, P=0.08) and in patients with SCORE<10% (SCORE<5%: 4.6, 9.2, 20.6, 60%, P<0.001; 5≤SCORE<10%: 9.8, 18.4, 20.8, 36.8%, P<0.05%; SCORE ≥10%: 25.0, 23.5, 35.4, 42.3%, NS). Concluding that the advantage of combined markers for SVD is doubtful in subjects aged 41 years or SCORE<1% due to low prevalence as well as in subjects aged 71 years or SCORE≥10% due very high prevalence and low additive predictive value.