Background: Arterial stiffness and pulse pressure are major risk factors of cardiovascular mortality and determinants of exercise capacity. Contribution of directly measured central pulse pressure for exercise capacity in healthy patients is not evaluated. We tested the hypothesis that central pulse pressure contributed to exercise capacity in patients without structural heart disease. Methods: We evaluated consecutive 60 patients (56.0 짹 10.4years old) without heart disease, who performed a symptom limited treadmill test as a pre-angiographic stress test. Structural heart disease was excluded by coronary angiography and echocardiography. Central aortic pressure was measured with 5-7Fr fluid filled pigtail catheter during angiogrphy. Treadmill test was performed with modified Bruce protocol and patients who had exercise limiting non-cardiac problems were excluded. Results: Mean exercise duration was 446.8 짹 114.5 seconds and 39 patients complained chest pain during exercise test. Mean aortic systolic and diastolic pressure was 151.3 짹 23.2 and 80.8 짹 11.2mmHg respectively. Mean peak rate pressure product during exercise test and heart rate recovery one minute after exercise was 30744.2 짹6458.0mmHg/min and 33.1 짹 18.6/min respectively. In univariated analysis, aortic pulse pressure(R²=0.189, p=0.001), age(R²=0.165, p=0.001), mean aortic pressure(R²=0.086, p=0.02), and heart rate recovery(R²=0.089 p=0.03) were significantly correlated with exercise duration. In multiple regression, only age was independently associated with exercise duration (p=0.03) and aortic pulse pressure had a marginal significance(p=0.08). Conclusions: In this study, aortic pulse pressure was a major determinant of exercise capacity in patients without structural heart disease.