Objective To investigate the alteration of central aortic systolic pressure (CASP) and vascular function in the patients with complicated hypertension. Methods A total of 344 volunteers undergoing noninvasive arterial pressure detection in the Department of Geriatrics of Ruijin Hospital from October 2009 to March 2013 were recruited in this study. They were divided into 3 groups: the normal control group (n＝124), controlled hypertension group (n＝67) and complicated hypertension group (n＝153). CASP, radial artery augmentation index of reflected wave (RAI), and peak relative time (PRT) were measured non-invasively by radial artery applanation tonometry BPro? (A-PULSE CASP? and corresponding software). Results CASP in the complicated hypertension patients whose blood pressure well-controlled was higher than that in the normal control group (P＜0.01), and had no significant difference with that of controlled hypertension group. There was no difference in vascular function between the 2 groups. For the complicated hypertension patients, CASP was significantly lower in those with well-controlled blood pressure than in those without (P＜0.01). Conclusion Well controlling blood pressure in the patients with complicated hypertension is helpful to reduce the CASP and improve the vascular function. And, monitoring CASP and vascular function can be used to predict clinical prognosis of blood pressure control.