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Objective: Our aim was to examine the impact of mismatch patterns reflecting pre- and post-natal growth conditions on markers of arterial stiffness and central hemodynamics in young adults. Methods: In all, 1056 participants from Malmö Offspring Study, 484 men and 572 women (age-range 18–44 years), were included. All participants were stratified into four subgroups based on low (≤0) or high (>0) Birth Weight z-score (BWz) and low (≤ median) or high (> median) Body Mass Index (BMI) at 20 years age (BMI20). All participants underwent carotid-femoral Pulse Wave Velocity (PWV) measurement and pulse wave analysis with Sphygmocor. Additionally, 24-h ambulatory blood pressure data was recorded in a subgroup of 184 participants. Results: Systolic Blood Pressure (SBP), central SBP (cSBP) and Diastolic Blood Pressure (DBP), and 24-h night-time SBP was higher (p < 0.001; p < 0.001; p = 0.04) in “low BWz/high BMI20” (mismatch group) compared with “low BWz/low BMI20” (reference). The mismatch phenotype was significantly associated with an increased risk of elevated brachial [odds ratio (OR), 2.78; 95% confidence interval (CI), 1.94–3.98] and cSBP (OR, 2.0; CI: 1.38–2.91) in young adults. No differences were observed in PWV or augmentation pressure index in comparison between “low BWz/high BMI20” and “low BWz/low BMI20.” Conclusion: Lower birth weight in combination with a higher attained BMI in young adult life, is associated with higher brachial SBP/DBP and central SBP/DBP. Therefore, children born with low birth weight should be protected from exaggerated catch-up growth to reduce their risk of adult hypertension, obesity, and adverse central hemodynamics. We aimed to examine the impact of mismatch patterns between pre- and post-natal growth conditions on markers of arterial stiffness and central hemodynamics in 1056 participants from a population-based study in Sweden, 484 men and 572 women in the age-range 18–44 years. •Lower birth weight was associated with higher Brachial DBP (bDBP), higher central SBP/DBP, and higher Aix. •Lower birth weight in combination with a higher attained BMI in young adult life (the mismatch phenotype) associates with higher bSBP/bDBP and higher central blood pressure. •We suggest an additive hemodynamic programming effect of weight gain during the two first decades of life following low birth weight.