The assessment of arterial stiffness, a common feature of aging, exacerbated by
pathological conditions like hypertension, has become an attractive tool for identifying structural and
functional changes of the arteries even in an early stage of the atherosclerotic disease. Arterial
stiffness has been recognized as an important physio-pathological determinant for the age-related rise
in systolic blood pressure, demonstrating also an independent predictive value for cardiovascular
events. In the recent decades, many techniques and indices to evaluate vascular stiffness have been
developed and extensive data concerning their prognostic value have been collected.
Moreover, it has become clear that vessel and heart must be considered as a unique system, in which combined stiffness
of vessel and heart interacts to limit cardiovascular performance.
In this review, main methods and indices used to estimate arterial and ventricular stiffness are presented, focusing on their
alteration in physiological aging and arterial hypertension. Furthermore, the concept of ventricular–arterial coupling is
explained in order to give an insight to the interplay between arterial and ventricular stiffness in aging and hypertension.