Background: The correlation between H-type hypertension and cerebral small-vessel diseases (CSVD) remains uncertain. The present study was designed to explore the possible relationship between H-type hypertension and CSVD spectrum and total burden. Methods: We included 329 patients in the present study and divided them into four groups: H-type hypertension group, the isolated hypertension group, the isolated hyperhomocysteinemia (HHcy) group and the control group. Clinical variables of interest and the MR examination sequences were obtained. We count the presence of each CSVD feature and rated the total burden of CSVD on an ordinal scale from 0 to 4 according to a recent described score rule. Results: The results showed that H-type hypertension was associated with the presence of CMB and the severity of WMH and PVS. CSVD total burden was significantly related to age (OR: 1.059, 95% CI: 1.037-1.082), systolic pressure (OR: 1.122, 95% CI: 1.007-1.136), triglycerides (OR: 1.386, 95% CI: 1.037-1.854), isolated HHcy (OR: 4.154, 95% CI 1.836–9.401) and H-type hypertension (OR: 5.028, 95% CI 2.323-10.883). And we further observed hypertension and HHcy had a synergistic effect on CSVD total burden (OR: 2.776, 95% CI 1.564-4.927). Conclusions: H-type hypertension may act as an independent risk factor of CSVD and cause increased susceptibility to CSVD total burden and CSVD spectrum, which deserved further prevention measures.
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