Purpose of review: Recent data have highlighted the shortcomings of the usual blood pressure hypothesis in posthoc analyses of randomized controlled trials led in populations at high cardiovascular risk and have emphasized the importance of an increased visit-to-visit variability of blood pressure in predicting cardiovascular events.
Recent findings: Over the last 2 years, the prognostic value of visit-to-visit blood pressure variability has been substantially confirmed in a wide spectrum of clinical populations, in studies investigating both cardiovascular outcomes and target organ damage.
Summary: There is an obvious need to design studies to prospectively determine the causes of increased visit-to-visit blood pressure variability, its best estimate and whether or not treatments that reduce blood pressure variability (and to what extent/target) improve clinical outcome.