Arterial stiffness refers to the loss of elasticity in the arterial wall that occurs with ageing, chronic hypertension, inflammation, and metabolic dysfunction. The aorta and central arteries function as compliant buffers, absorbing the pressure wave from each heartbeat and releasing it smoothly between beats. When arteries stiffen, this buffering function is lost, and the pressure wave travels to the peripheral circulation faster and with greater force. The consequence is elevated systolic blood pressure, increased pulse pressure, greater strain on the heart, and impaired perfusion of the coronary arteries and brain.
Pulse Wave Velocity as a Biomarker
Pulse wave velocity, the speed at which the pressure wave travels from the aorta to peripheral vessels, is the gold standard measurement of arterial stiffness. It is a stronger predictor of cardiovascular events than systolic blood pressure alone, and it reflects cumulative vascular damage rather than just the current haemodynamic state. In clinical research settings, it is measured using applanation tonometry; consumer devices and some research-grade blood pressure monitors now provide proxy estimates.
What Reduces Arterial Stiffness
- Aerobic exercise: consistent evidence that zone 2 and vigorous aerobic training reduces pulse wave velocity over months of training
- Blood pressure control: normalising blood pressure is the most powerful single intervention for slowing arterial stiffness progression
- Reducing dietary sodium: chronic high sodium intake accelerates arterial stiffening independently of blood pressure
- Omega-3 fatty acids: EPA and DHA from oily fish reduce aortic stiffness markers in several randomised trials
- Reducing advanced glycation end products: dietary AGEs from processed and high-heat-cooked foods cross-link collagen in vessel walls, directly increasing stiffness
- Nitrate-rich vegetables: dietary nitrates are converted to nitric oxide, which relaxes vascular smooth muscle and acutely reduces arterial stiffness
Sources
- Laurent, S., et al. (2006). Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension, 37(5), 1236-1241.
- Tanaka, H., et al. (2000). Exercise training and arterial aging. Arteriosclerosis, Thrombosis, and Vascular Biology, 20(6), 1445-1452.
- Vlachopoulos, C., et al. (2010). Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology, 55(13), 1318-1327.