Hypertension is one of the common clinical diseases, and at present, there are 160 million adult patients in China, and there are “three highs” (high incidence rate, high disability rate and high mortality rate) and “three lows” (low awareness rate, low treatment rate and low control rate) in both urban and rural areas. (low awareness rate, low treatment rate and low control rate). It mainly damages the heart, brain, kidneys, large and medium arteries and other target organs, and is the main cause of stroke in China. The disease is a progressive cardiovascular syndrome, which is the result of the interaction of many pathogenic factors leading to pathological changes in cardiovascular function and structure. The goal of treatment is to reduce blood pressure to normal (or near-normal) levels, correct cardiovascular risk factors, prevent complications, and reduce disability and death rates. The principles of treatment are: active improvement of lifestyle, adherence to antihypertensive drugs with good efficacy, few side effects and quality of life, adherence to the principle of individualization in terms of efficacy, and emphasis on the principle of living within one’s means in terms of economics. Clinical interventions include both pharmacological and non-pharmacological treatments, which are also called the “right and left hands of hypertension treatment”. Non-pharmacological treatment includes: low salt and low fat, smoking and alcohol cessation, weight loss, aerobic exercise, adequate intake of fruits and vegetables rich in potassium, calcium, magnesium, vitamins, fiber and trace elements, maintaining regular bowel movements, reducing mental stress and maintaining psychological balance, etc. Drug therapy: At present, the most commonly used clinical antihypertensive drugs have five categories – angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, beta receptor blockers, calcium channel blockers (also divided into three categories: dihydropyridines, phenylalkylamines and thiodiazepines), diuretics (also divided into thiazides, tab diuretics, potassium-protective diuretics and sulfonamides). sulfonamides). In addition, alpha-blockers, vasodilators and some compound preparations (including western medicine compound and Chinese medicine compound) are also often used in clinical practice. At present, there are short-acting, medium-acting and long-acting antihypertensive drugs on the market, and there are different forms of immediate-release, slow-release and controlled-release. A competent cardiovascular physician, not only to understand what drugs patients can use, but also to know what drugs can not be used for a particular patient, the latter is more important than the former in clinical practice, but also can see the real work. A good antihypertensive drug should meet at least three conditions: good antihypertensive efficacy, positive cardiovascular protection, high safety and patient compliance. At present, there are two main indicators to evaluate the antihypertensive efficacy, namely the smoothing index and the trough-to-peak ratio. The former is the ratio of the mean and standard deviation of the hourly change in blood pressure after drug administration, and the latter represents the ratio between the trough and peak effect values of blood pressure lowering. Therefore, the drug with higher smoothness index and valley-to-peak ratio is the better antihypertensive drug in terms of efficacy. According to domestic and international treatment guidelines, our current antihypertensive targets for hypertension are: general patients should have at least systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg, elderly people should have systolic blood pressure <150 mmHg and diastolic blood pressure <90 mmHg (but should be ≥65 mmHg), and patients with diabetes and renal disease should have systolic blood pressure <130 mmHg and diastolic blood pressure <80 mmHg. According to the The characteristics of the changes in the patients' ambulatory blood pressure, it is scientific to set a reasonable time of medication administration. For general patients who only need to take medication once a day, 6-7 a.m. is preferred because the law of human biological clock indicates that this is the beginning of the rising limb of the blood pressure curve, and taking medication at this time helps to suppress the peak of the patient's blood pressure, so that it does not become too high. If 2-3 doses of the medication are required daily, they should also be taken in the evening or before bedtime. In mild cases of hypertension, only one drug can be used, while in severe cases, a combination of drugs should be used. The "Rule of TENS" principle (10 mm Hg principle) has been proposed internationally, that is, a drug can generally reduce systolic blood pressure by about 10 mm Hg, so people with high blood pressure levels often need to combine two or more drugs to achieve the target. For those with hyperlipidemia, diabetes mellitus, hyperuricemia, coronary artery disease and renal disease, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and calcium channel blockers are preferred, and for those with exertional angina, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and diuretics are preferred, and for those with spontaneous angina, calcium channel blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists and diuretics are preferred. angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, etc., and those with heart failure can choose angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, diuretics or beta-blockers, etc. In summer hypertension patients, blood pressure is often lower than usual during regular antihypertensive treatment, which is related to the high temperature in summer that causes vasodilation of the body and more sweating that leads to a reduction in circulating blood volume, so a large number of diuretics should not be used to avoid electrolyte disorders. At this time, the use of other types of antihypertensive drugs should also be appropriately reduced to avoid postural hypotension, or low blood pressure affecting the coronary artery blood supply. Elderly patients, those with cerebral arteriosclerosis or carotid plaque formation, those in the acute stage of cerebral infarction, and those with renal insufficiency should lower their blood pressure slowly and gently, not too fast and too hard, otherwise there will be a risk of causing or aggravating ischemic cerebrovascular disease and renal failure. At the same time, elderly patients and cerebral arteriosclerosis, should not watch too competitive sports, so as not to cause hemorrhagic cerebrovascular disease due to emotional excitement. Patients with Alzheimer's disease must be supervised by a family member to take medication so as not to trigger medication errors or overdose, and once-a-day medication is preferred. In case of sudden rise in blood pressure or hypertensive crisis, sublingual nifedipine can be used immediately (but use with caution in the elderly), or captopril or atenolol (I have used atenolol or propranolol sublingually for many times in clinical practice and obtained results). Of course, it depends on the heart rate to choose antihypertensive drugs. If the blood pressure is too high and the heart rate is slow, nifedipine is preferred; if the blood pressure is too high and the heart rate is tachycardic, atenolol is preferred; if the blood pressure is too high and there is no arrhythmia, captopril can be chosen. For those who need long-term hemodialysis due to hypertension or other disorders, long-acting antihypertensive drugs (such as nifedipine controlled release, amlodipine, etc.) should be used, but attention should be paid to monitoring the changes in blood pressure, because renal insufficiency can affect drug metabolism and lead to drug accumulation, which can cause excessive blood pressure lowering. At the same time, the blood pressure level is often high immediately after hemodialysis, so a rapid-acting antihypertensive drug (such as nifedipine) can be added temporarily to control blood pressure quickly. Those who need to maintain nasal nutrition for a long time due to other diseases should choose long-acting drugs (such as temisartan, amlodipine, etc.) and avoid choosing slow-release or controlled-release dosage forms. The key technology of these slow-release, controlled-release dosage forms is mostly in the shell of the drug, and once the drug is crushed, it becomes an ordinary dosage form, which is not conducive to the stability of blood pressure. At the same time, patients with various causes of urinary retention may also experience a sustained increase in blood pressure, which clinicians should not be unaware of. In addition, the side effects of commonly used drugs should be well understood and properly informed when treating patients in order to avoid unnecessary disputes. For example, angiotensin-converting enzyme inhibitors can cause dry cough and abnormal taste; long-term application of thiazide diuretics can have abnormal metabolism of blood lipids, blood sugar and uric acid; beta-blockers can cause slowed heart rate and weakness, and long-term use of non-selective beta-blockers can also lead to disorders of blood lipid and blood sugar metabolism; dihydropyridine calcium channel blockers often cause lower edema, facial and neck flushing, increased heart rate, etc.