Arterial distensibility decreases with age and atherosclerosis leading to increased pulse pressure (PP) and increased left ventricular work, resulting in left ventricular hypertrophy, a risk factor for cardiovascular morbidity. Brachial artery pulse curve data were collected using the DynaPulse 2000A. Distensibility measured in 920 healthy young adults (40% men, 70% white, age range 18 to 38 years) was compared with levels of cardiovascular risk factors. Laboratory, anthropometric, blood pressure (BP), and heart rate measurements were also obtained. Distensibility tended to decrease with age, reaching significance in women (p <0.05). Whites had greater distensibility adjusted for age than blacks, with women more than men (p <0.05). Distensibility adjusted for PP was negatively correlated with measures of body size, BP, glucose, insulin, low-density lipoprotein cholesterol, very low density lipoprotein cholesterol, and age (p <0.05). When distensibility was plotted as a function of PP to control for distending pressure, the lowest quintiles of systolic, diastolic, and mean arterial BPs tended to have greater distensibility. No differences were seen by quintiles of lipids. In multivariate analyses, BP, age, anthropometric measures, gender, and very low density lipoprotein cholesterol entered the model (r(2) = 0.56; p <0.02). Thus, brachial artery distensibility, which includes a normalization factor to control for body size, showed race and gender differences (whites and women had greater distensibility than blacks and men, respectively), even after adjustment for age. Stiffer vessels with decreased distensibility were seen in subjects with higher levels of cardiovascular risk factors across the range of normal PP. Therefore, noninvasive measures of distensibility are useful in measuring subclinical vascular changes related to arteriosclerosis.