The association of optimal blood pressure (BP) control and arterial stiffness was evaluated in 172 patients with chronic kidney disease. The authors compared the augmentation index (AIx) of patients who achieved a recommended BP goal (<130/80 mm Hg) with those who did not (> or = 130/80 mm Hg). The median age was 57 years, 60% were male, and 70% were Caucasian. One-third of patients had achieved a BP goal of <130/80 mm Hg. AIx was significantly lower in patients who achieved BP goal than in those who did not (median AIx, 19% vs 23%; P=.04). AIx remained significantly lower in patients who achieved the BP goal, after adjusting for age, sex, and height (mean effect on AIx, -3.3%; 95% confidence interval, -6.1% to -0.4%; P=.03). Achievement of BP goal of <130/80 mm Hg in chronic kidney disease patients is associated with significantly lower AIx and may reflect a reduction in overall arterial stiffness.