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Background Central blood pressure (BP) is pathophysiologically more important than peripheral BP for the pathogenesis of cardiovascular disease.Arterial stiffness is also a good predictor of cardiovascular morbidity and mortality.The effects of benidipine,a unique dual L-/T-type calcium channel blocker,on central BP have not been reported.This study aimed to compare the effect of benidipine and losartan on the central BP and arterial stiffness in mild to moderate essential hypertensives.Methods This 24 weeks,multi-center,open label,randomized,active drug comparative,parallel group study was designed as a non-inferiority study.The eligible patients (n=200) were randomly assigned to receive benidipine (n=101)or losartan (n=99).Radial artery applanation tonometry and pulse wave analysis were used to measure the central BP,pulse wave velocity (PWV) and augmentation index (Alx).We also measured the metabolic and inflammatory markers.Results After 24 weeks,the central BP decreased significantly from baseline by (16.8+14.0/10.5+9.2) mmHg (1mmHg =0.133 kPa) (systolic/diastolic BP; P ＜0.001) in benidipine group and (18.9+14.7/12.1+10.2) mmHg (P ＜0.001)in losartan group respectively.Both benidipine and losartan groups significantly lowered peripheral BP (P ＜0.001) and Alx (P ＜0.05),but there were no significant differences between the two groups.The mean aortic,brachial and femoral PWV did not change in both groups after 24-week treatment.There were no significant changes of the blood metabolic and inflammatory biomarkers in each group.Conclusion Benidipine is as effective as losartan in lowering the central and peripheral BP,and improving arterial stiffness.