Introduction. Hypertension (HT) is a significant and independent risk factor for the development of cerebrovascular disease, which is a leading cause of death and disability and is one of the most common cardiovascular diseases in most countries of the world. In Ukraine, the percentage of patients with arterial hypertension is between 30 and 41%, which is more than 12 million patients. the aim of our research-to improve the diagnostic approaches of cerebrovascular disorders in patients with hypertensive encephalopathy (HE) by clarifying the development of pathogenetic mechanisms, based on a comprehensive clinical and paraclinical study. Materials and methods. Clinical and neurological examination; neuropsychological examination; instrumental examination (chronobiotic structure of blood pressure (ВР) according to daily blood pressure monitoring; heart rate variability (HRV); single photon emission computed tomography (SPECT); laboratory testing (determining homocysteine levels). results. The normal level of homocysteine (GC) has been registered among 64.7% of patients with HE, moderate increase of GC has been noticed in 5.9% of cases, and a significant degree of increasment-only among 2.9% of patients. The spectral analysis of HRV has shown a decrease in the values of indicators of the overall variability of the heart rate, accompanied by a weakening of the parasympathetic and increased sympathetic effects on the cardiovascular system. conclusions. It has been established that vascular lesions of the retina, signs of left ventricular hypertrophy and hypercholesterolemia were more commonly observed among patients with HE II stage than among patients HE stage I. According to the results of daily blood pressure monitoring, changes in the parameters among patients with HE І stage, were characterized by an increase in pulse pressure (especially at night) in conjunction with an increase in the rate of morning blood pressure. High pulse pressure is accompanied by a decreasement of brain perfusion (according to the SPECT) and this is an independent risk factor for the development of HE.