Abstract: Objective：To evaluate the correlation between changes in brain metabolism and the reduction in small arteries in patients with hypertension. Methods：Fifty patients with hypertension and fifty volunteers without hypertension were enrolled. The two groups underwent 3T 3D time of flight MR angiography (MRA) and Single voxel proton MR spectroscopic (MRS). The numbers of lenticulostriate arteries (LSAs) and the ratios of Nacetylaspartate to creatine (NAA/Cr), myoinositol to creatine (MI/Cr), and choline to creatine (Cho/Cr) on the basal ganglia regions were calculated. Results：The average total number of LSA stems on both sides in patients with hypertension and volunteers without hypertension was 5.12±0.98 and 6.10±0.95, respectively (P＜0.000 1). The NAA/Cr ratio decreased according to a reduction in the number of LSAs in the hypertension group, which was significantly reduced when the number of LSAs was 3 or fewer. Conclusions：Hypertension can lead to a statistically significant reduction in NAA/Cr ratio on the basal ganglia regions when the number of LSAs decreases to a certain extent.