Hardening of the pulse, first described thousands of years ago by Chinese healers, was known even then to be an adverse prognostic sign. In Western medicine, the association of aging, increased large-arterial stiffness, and systolic hypertension has been recognized for more than a century. Yet the adverse consequences of age-related arterial stiffening still receive little attention in everyday clinical practice, perhaps because clinicians assume that nothing can be done about the process. Recent developments, however, suggest that improved clinical recognition of age-related vascular stiffening will lead to better therapy and improved outcomes for patients with hypertension.