Stiffening of large arteries is an important element of vascular ageing, leading to isolated systolic hypertension and increased cardiovascular risk. This has been recognized by the 2007 ESC/ESH guidelines for the management of hypertension. Pathophysiological alterations of large arteries are related to hypertensive disease, atherosclerosis, diabetes mellitus, end-stage renal disease, smoking, hyperlipidaemia and many other factors. Therefore, methods of assessing arterial function and structure are important in the modern management of cardiovascular disease, both in terms of risk assessment and therapy.