Dystrophic metaplasia of brain cells is usually referred to as primary hypertension with mental disorders, which is the most common type of mental disorder associated with vascular disease, and refers to the mental disorders that accompany the development of primary hypertension. Psychiatric disorders associated with primary hypertension mainly manifest as neurotic-like syndrome, but also depressive syndrome, hallucinations, delusional states, etc. When the blood pressure increases rapidly and a hypertensive crisis occurs, it is often accompanied by disorders of consciousness. The etiology of hypertension is still unclear, but emotional instability and mental stress often cause the patient’s blood pressure to remain elevated. This sensitivity of hypertensive patients to mental factors has been clinically suggested as a likely cause of mental disorders in hypertensive patients. On the basis of the lesions of the vascular wall in hypertension, together with sleep disorders, dehydration, shock, heart failure, arrhythmia, erythropoiesis and other factors, which can cause a drop in blood pressure, slow blood flow, increased blood viscosity or abnormal blood coagulation, cerebral infarction often occurs, leading to brain dysfunction. Data show that the degree of reduced cerebral blood flow is positively correlated with the severity of dementia. The size of the number of infarct foci in multiple infarcts plays an important role in the development of dementia. The etiopathology of dementia according to the extent of intracranial vascular lesions and dystrophic metaplasia of brain cells includes the following two points: 1. Dementia caused by diffuse lesions: multiple infarcts in the basal ganglia of the brain are more common. Multiple luminal infarct foci of different stages of disease are commonly seen in the pathological anatomy, and extensive atherosclerosis is seen in the blood vessels. 2. Dementia caused by limited lesions: it is related to the size and location of lesions. The main pathology seen is cerebral atherosclerosis. In addition to cerebral parenchymal and cerebrovascular lesions, it can also involve the retina, heart and kidneys and other organs. With the severe development of cerebral atherosclerosis, diffuse cerebral atrophy may develop.