BACKGROUND: Aortic pulse wave velocity (aPWV), an index of aortic distensibility, and postprandial hypertriglyceridemia are recognized as independent cardiovascular risk factors. HYPOTHESIS: The aim of this study was to evaluate the relationship between postprandial hypertriglyceridemia and changes in aPWV. METHODS: We prospectively studied 45 patients (mean age 48  years, 28.9% men), who were submitted to a standardized fat meal (FM) test. According to their triglyceride (TG) levels 2, 4, 6, and 8 h after the FM, the patients were divided into two groups: Group 1 (31 patients) with postprandial TG levels < or = 219 mg/dl, and Group 2 (14 patients) with TG levels > 219 mg/dl at one of the aforementioned time intervals. Before and 6 h after the FM, aPWV was measured noninvasively. RESULTS: Baseline characteristics in the two groups were similar, except for higher TG, pulse pressure, waist-to-hip ratio, percentage of patients who smoked or had arterial hypertension, and lower high-density lipoprotein cholesterol levels in Group 2. Postprandially, aPWV was higher in Group 2 [11.2(2.7) vs. 9.1(2.1) m/s, p = 0.004]. Changes in aPWV correlated with TG changes from baseline to 6 h after FM (r = 0.539, p < 0.001) and with the areas under the TG curve (r = 0.617, p < 0.001). A postprandial TG increase of 100 mg/dl resulted in a 0.88 m/s rise of aPWV. CONCLUSION: An increase in aPWV 6 h after an FM test correlates positively with abnormal postprandial hypertriglyceridemia. These relationships, reported here for the first time, could be of practical use for better evaluation of patient prognosis.