[Risk factors for subcortical arteriosclerotic encephalopathy].

Subcortical arteriosclerotic encephalopathy (SAE) is a chronic progressive form of brain blood supply deficiency. Risk factors for SAE development were studied in 65 patients (42 men and 23 women, mean age 60.5 +/- 7.5 years). A control group included 31 patients (17 men and 14 women, mean age 59.3 +/- 7.4 years) with isolated clinically meaningful lacunar infarcts. A main risk factor for SAE was arterial hypertension (AH) emerging in 98.5% of the patients, which, according to twenty-four hour monitoring, differed significantly from that in the patients with isolated lacunar infarcts. In SAE, diastolic pressure was higher, systolic AP variability was detected more frequent, physiological AP decreased rarely in the nighttime, but AP fell down extremely more often. A frequency of other risk factors (ischemic disease, atrial fibrillation, diabetes mellitus, smoking, elevation of hematocrit, fibrinogen and platelet aggregation) did not differ significantly comparing to isolated lacunar infarcts. Hypercholesterolemia was detected more frequently in the controls than in the SAE patients. The study revealed that AP with hemodynamic features, pathogenetically crucial for development of disseminated arteriolosclerosis in small brain arteries and arterioles as well as for diffuse white matter damage in brain hemispheres characteristic for SAE, is a main risk factor for SAE.