Elevated peripheral (brachial) blood pressure (PBP) is related to hard cardiovascular outcomes and remains the main target for antihypertensive therapy. However, central aortic blood pressure (CABP) can be measured noninvasively and could potentially prove to be a more important marker of cardiovascular diseases in future. Several studies have shown association of CABP with cardiovascular mortality, coronary artery disease, left-ventricular hypertrophy and atherosclerosis. Furthermore, the impact of various classes of antihypertensive agents on CABP is different from their impact on PBP. We review the significance of CABP in cardiovascular outcomes and the differential impact of antihypertensive therapy on CABP.