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Stiffening of arteries occurs when the pressure load is transferred from distensible elastic structures to less distensible components in the arterial wall.The causes are multifactorial and complex, involving both cellular and non-cellular mechanisms.While the fatiguing effects of unceasing mechanical pulsations contribute to passive mechanisms,which are essentially not reversible, modifications of the extracellular matrix driven by molecular process also play a significant role, and have the potential to be reversed.