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Classically, the smooth muscle walls of the aorta and other large conduit arteries are believed to behave as passive elastic tubes undergoing periodic distension with the pulse wave. This is in contrast to data that suggest that an active contraction-relaxation cycle occurs in synchrony with the cardiac cycle. In this paper data are reviewed, and the conclusion is reached, that the aorta undergoes an active contraction in synchrony with the heartbeat. These contractions show an upstroke in tension during the rising phase of the pulse wave, prompting the nomenclature pulse synchronized contractions, or PSCs. PSCs are eliminated by blockers of neural transmission, and the pacemaker for these events resides in the right atrium, potentially allowing for coordination between cardiac and vascular contractility. Understanding the contractile behavior of the aortic smooth muscle wall may both yield new targets for therapeutics as well as help to further explain the etiology of cardiovascular disease processes.