Nakanishi K, et al. - In a population based, predominantly elderly cohort without prior stroke (n= 828), who had 24-h ambulatory blood pressure (BP) monitoring (ABPM), 2D echocardiography and brain magnetic resonance imaging in the Cardiac Abnormalities and Brain Lesion (CABL) study, researchers examined the associations of office and ambulatory BP values with subclinical cerebrovascular disease. They assessed the associations of BP measures with the presence of silent brain infarct (SBI) and upper quartile of log-white matter hyperintensity volume (WMHV) (log-WMHV4). Independent of cardiovascular risk factors, and pertinent echocardiographic parameters, a significant association of only night-time systolic BP (SBP) with SBI was seen in multivariable analysis. Significant associations of daytime, night-time, 24-h BPs, and non-dipping pattern, with log-WMHV4, were evident, but the strongest association was reported for night-time SBP. Overall, elevated night-time SBP was strongly related to subclinical cerebrovascular disease. Subjects at higher risk of hypertensive brain injury can be detected by night-time SBP by ABPM.