Some patients often consult us due to high blood pressure fluctuations, which cause a lot of discomfort and tension. Based on our experience in actual work, we can summarize the causes of such large blood pressure fluctuations into 4 areas. 1. Inappropriate use of medication. We have conducted 24-hour ambulatory blood pressure monitoring in hypertensive patients who thought their blood pressure was ideally controlled and found that nearly half of them had unstable blood pressure. The manifestations include: (1) elevated blood pressure in the morning; (2) elevated blood pressure in the afternoon; (3) elevated blood pressure in both the morning and afternoon; (4) unsatisfactory blood pressure control at night; (5) large changes in blood pressure fluctuations; (6) elevated blood pressure during activities. Therefore, it is common to see this phenomenon in clinical practice. Some patients have cardiovascular emergencies even though they take their medications carefully and usually have good results. Analysis of the reasons for these phenomena are two: one is currently taking short-acting antihypertensive drugs; the second is not in accordance with the law of blood pressure fluctuations medication. 2, primary hypertension accompanied by special circumstances. Such as women’s menopausal hypertension, this period due to fluctuations in the body estrogen changes, panic, chest tightness, sweating and other symptoms of the menopause syndrome, but also correspondingly large fluctuations in blood pressure. At this time, if systematic treatment of menopausal syndrome is carried out under the guidance of a physician, the patient’s blood pressure will also appear stable. For patients with essential hypertension who have other systemic diseases such as ureteral calculi and cholecystitis, the onset of these diseases can lead to fluctuating blood pressure increases. After timely treatment of these diseases by the appropriate specialist, the patient’s blood pressure will of course be stabilized. 3. Certain secondary hypertension. It is known that some patients with hypertension are caused by certain diseases, called secondary hypertension. The most prominent manifestation in some patients with secondary hypertension is the large fluctuations in blood pressure, which is also the easiest for clinicians to notice and patients’ families to play ignore. For example, in one young female patient, lying flat was a significant increase in blood pressure, and we diagnosed pheochromocytoma, secondary hypertension grade 3, a very high risk group. After giving the patient adequate preparation and surgical removal of the pheochromocytoma the symptoms disappeared and the blood pressure returned to normal. 4. Hypertensive target organ damage. The greatest danger of hypertension to humans is to cause target organ damage such as heart, brain and kidney and cardiovascular disease. In hypertensive patients who already have cardiovascular disease, when cardiovascular disease emergency attacks, it can cause sympathetic excitation and increase blood pressure. For example, in one case of a patient with chest pain during activity, we measured blood pressure of 180/90 mm Hg during a room visit and immediately asked the patient what was wrong with him. The patient said that he now had chest pain, and an electrocardiogram was done immediately to find evidence of inadequate coronary artery supply, and we immediately gave oxygen and nitroglycerin, and the patient’s blood pressure returned to normal after the symptoms subsided. In addition, during some periods of instability of cerebrovascular disease, the patient’s blood pressure can fluctuate and rise. It can be seen that the causes of blood pressure fluctuations in hypertensive patients are multiple and the condition can be identified and brought under control to the desired level. As long as hypertensive patients with high blood pressure fluctuations are treated by a specialist in a timely manner, the patient’s blood pressure can be stabilized and normalized so that the patient’s heart, brain and kidneys are eventually protected.