Evidence is accumulating in support of the plausible notion that lower arte
rial elasticity is associated with an increased risk of cardiovascular dise
ase manifestations. Conventional indices of arterial stiffness are compared
to a newer method (blood pressure-adjusted pulsatile arterial diameter cha
nge) in terms of blood pressure dependence. Impaired elasticity of larger a
rteries is an antecedent factor in the natural history of blood pressure el
evation at the population level. Strong evidence supports the notion that l
ower arterial elasticity in the medium-sized arteries is associated with th
e development of hypertension.