See article vol. 29 : 174-187 Subclinical cerebrovascular diseases (SCVDs) refer to all pathologic processes that affect the small and large vessels of the brain. Magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) enable us to easily detect SCVDs, including small vessel diseases in the brain. SCVDs have been associated with all-cause mortality, future cardiovascular diseases, cognitive impairment, dementia, or decline in high-level functional capacity. To extend not only patients' but also healthy individuals' healthy life expectancy, small vessel disease in the brain should be a target for preventive and treatment strategies. The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA), which is a cohort study of Japanese men, assessed the associations of blood pressure (BP) levels from two separate examinations with lacunar infarcts, periventricular hyperintensity (PVH), microbleeds, deep and subcortical white matter hyperintensity (DSWMH), and intracranial artery stenosis (ICAS).