The importance of average blood pressure monitoring in patients with risk factors for cerebrovascular pathologies as an indicator that reflects the different degrees of structural brain damage was proved. The importance of determining the pressure load index by ambulatory blood pressure monitoring to assess the formation of structural brain damage in the initial manifestations of chronic cerebral ischemia was established. Excessive blood pressure decreasing at night may also have prognostic value for the formation of clinically significant manifestations of chronic cerebral ischemia. In patients with initial manifestations of chronic cerebral ischemia without structural brain damage should pay attention to the rate of systolic blood pressure increasing in the morning.