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It is important that new clinical measures can identify risk factors and predict cardiovascular events. Although the walking speed (WS) test is a potential candidate, consolidating data from multiple studies is required to determine comparative references. We examined the associations of WS measures with markers of cardiovascular risk and with cardiovascular events in noninstitutionalized subjects older than 60 years. A systematic review of observational studies was conducted using MEDLINE and SCOPUS from inception of the databases to December 2014, aiming at studies that evaluated WS as the primary outcome (usual or maximal pace) within a distance ≤20 m associated with cardiovascular health. All 15 included studies (29,845 subjects) reported significant associations of WS with different cardiovascular risk factors (coronary artery calcification, C-reactive protein, hypertension, diabetes, and intima-media thickness) and occurrence of cardiovascular events (peripheral artery disease, stroke, and mortality). Approximately 80% of the studies used a distance ≤6 m and WS at usual pace. There was high heterogeneity in the risk thresholds established by different studies. Our results suggest usefulness of the WS test as a tool for cardiovascular risk stratification in older adults. However, the variation in speed thresholds and diversity of protocols among studies suggest caution when generalizing results to different older adult populations. Because the WS test is a simple, cheap, and safe tool to administer, we make suggestions for its standardization in future studies. [ABSTRACT FROM AUTHOR]