Editorial Commentary Arterial Stiffness, Fatness, and Physical Fitness Ready for Intervention in Childhood and Across the Life Course?

Arterial distensibility and its converse stiffness have comeof age as physiological concepts1 and now as a target for intervention. The central hypothesis sustained so far is that an individual’s “arterial stiffness ” measured as aortic pulse wave velocity (PWV) is a convenient, integrated index of vascular pathology over a person’s life course, more precise and reliable than other risk factors individually. For example, blood pressure (BP), whether casual or 24 hour, is more sensitive to stimuli and, therefore, more variable. Arterial distensibility is in part dependent on BP, yet its prognostic power is because of its “independence ” from BP, including pulse pressure.2 It appears to indicate the general burden of atherosclerotic disease and subclinical damage from mul-tiple risk factors over time: the “wear and tear ” of constant distension and recoil (part of “aging”), effects of smoking, lipid metabolism, (hyper)glycemia, ethnicity, how famil