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See related article, pp 148–157 The role of office and ambulatory 24-hour measurement of brachial blood pressure (BP) on the assessment and prediction of cardiovascular risk and mortality has been well established. In addition, the independent predictive value of office measurement of carotid-to-femoral pulse wave velocity (PWV), a surrogate of arterial stiffness, has been reported in longitudinal prospective studies and further confirmed by several meta-analyses. Indeed, the assessment of arterial stiffness at the office or clinical setting has gained a place in the latest (2013) European guidelines with an indication (Class IIa; Level of Evidence B) for evaluation of subclinical organ damage in hypertensive patients. Along with the growing clinical interest on the field, a variety of promising devices were introduced by the industry, which, however, led to known and new methodological concerns and debates thus resulting to the establishment of consensus reports and guidelines for their standardization.1 Several parallel studies have investigated the potential predictive value of central BP and aortic wave reflections, beyond and above peripheral (ie, brachial) BP values, but the provided evidence remains cloudy. With the advancement of technology, similarly to the ambulatory BP monitoring (ABPM) at the brachial artery, it is now feasible to monitor and evaluate the 24-hour (or longer) variation of arterial stiffness, wave reflections, and central BP at ambulatory conditions.2 Several commercially available devices exist for the above purposes as thoroughly described previously,3 providing a new tool to assess vascular function and properties at a circadian level. Numerous studies have demonstrated the prognostic value of ambulatory arterial stiffness in various populations and especially in hypertensive patients.3 Most commonly, the ambulatory arterial stiffness index, calculated using BP indices derived by brachial ABPM, has been applied for the assessment of 24-hour variation of arterial stiffness. Recently, the RENIS cohort investigated …