Introduction: Arterial stiffness has been proposed as an important predictor of cardiovascular (CV) event in various groups, such as end-stage kidney disease and hypertensive patients. Although, blood pressure (BP) is one of the most important determinants of arterial stiffening, there are some cases who have a discrepancy between BP and arterial stiffness. In this study, we evaluated the impact of arterial stiffening on impairment of cardiac parameters and incidence of CV event in patients with normal blood pressure. Methods: A total of 320 outpatients with normal BP defined as systolic BP less than 140mmHg were enrolled. At baseline, all subjects underwent echocardiography and MDCT. Coronary artery calcification (CAC) was evaluated with Agatston method and CAC score (CACs) was calculated. Arterial stiffness was also assessed with pulse wave velocity (PWV) between brachial and ankle. The subjects were divided into two groups according to the PWV: high PWV group (PWV≥18m/sec, n=89) and low PWV group (PWV<18m/sec, n=231). Cardiac parameters as well as incidence of CV events during the follow-up period were compared between the two groups. Results: In linear regression analysis, PWV was significantly associated with CACs and NT-proBNP after adjustment for confounding factors. In multivariate logistic regression analysis, PWV over 18m/sec was significantly associated with CACs over 400 with a hazard ratio of 2.466 (95%CI: 1.012-6.009, p=0.047). Kaplan-Meier analysis showed that high PWV group had higher rate of CV event during the follow-up period of 575 days (20% vs 6%, p=0.0003). In multivariate Cox regression analysis, PWV over 18m/sec was an independent predictor for future CV events with an odds ratio of 2.534 (95%CI: 1.045-6.146, p=0.040). Conclusions: Arterial stiffening assessed by PWV is a strong determinants of impairment of cardiac parameters as well as future CV event even in normotensive patients.