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Central arterial pressure, central pulse pressure, arterial stiffness reflected by pulse wave velocity, and other parameters of central hemodynamics provide a new insight into cardiovascular pathophysiology associated with ageing, hypertension, diabetes, and end-stage renal disease. Therefore, a new understanding of the mechanisms of target organ damage, their prevention and treatment is enabled. Consequently, new interventional studies involve measurements of central arterial pressure besides peripheral blood pressure. Despite similar peripheral blood pressure control, there is a difference in cardiovascular events between groups under different antihypertensive treatment. This difference can be attributed to diverse effects on central pressure waveforms. Studies have demonstrated that improvement of central arterial pressure results in the reduction of cardiovascular events. Therefore, central arterial pressure has a higher prognostic value than peripheral blood pressure. Additionally, pulse wave velocity is considered a strong independent predictor of cardiovascular risk. New approaches to reducing arterial stiffness are studied in recent research. This article reviews the value of central arterial pressure and pulse wave velocity in pathophysiology and among risk factors for cardiovascular events.