Blood pressure is essentially the lateral pressure of the fluid flowing inside the blood vessels against the walls of the blood vessels, which varies with the systole and diastole of the heart. The lateral pressure of the blood against the walls of the tubes during systole is called systolic blood pressure, and the lateral pressure of the blood against the walls of the tubes during diastole is called diastolic blood pressure. A systolic blood pressure of more than 140 mmHg and a diastolic blood pressure of more than 90 mmHg is considered high blood pressure. Hypertension often kills people invisibly and is known as the silent killer, but it is not uncontrollable. Correcting misperceptions in the diagnosis and treatment of hypertension, educating the awareness of risk perception, and emphasizing on goal management and follow-up will surely overcome hypertension. Step 1: Hypertension should be detected “before it is too late” Hypertension diagnosis is quite simple, a blood pressure meter can be done, the reason why there is a delay in the diagnosis is not measured, wait until the appearance of dizziness, headache and other symptoms and then go to measure it is often too late, which is very common in the clinic, the young people are particularly serious. Young people often rely on their own health, lazy checkups, even if they find high blood pressure, but also delay the choice of treatment, always hoping to “wait a while”, until no longer young and then treatment has often been a major disaster. Disease focuses on prevention, prevention than treatment can save more human and material resources and financial resources, this year’s new crown epidemic is clear evidence. China’s hypertension incidence rate of 30%, and is still rising year by year, the age of onset is also advancing, as the mainstay of society and the family of young and middle-aged hypertension is to become a group of high blood pressure in the “force”, if not early prevention and early control, 10 to 20 years after the impact on the family and society is unimaginable. Therefore, we would like to remind you to pay attention to medical checkups in order to detect hypertension “before it is too late”, and to pay more attention to the importance of early detection for individuals with a family history of hypertension. Step 2: Monitor blood pressure and get out of the misunderstanding of measurement Blood pressure monitoring is very important for hypertensive patients. Which one is more responsive to the real condition of blood pressure: blood pressure measured in the clinic, blood pressure measured at home or 24-hour blood pressure monitoring? Is blood pressure measured in the office really more accurate? In fact, blood pressure measured in a noisy clinic environment is usually higher than that measured at home. In comparison, home blood pressure measurement is more reflective of the real blood pressure in normal life situations. A misconception about home blood pressure measurement is that the more frequent the measurement, the better, or even measure blood pressure once an hour, which reflects the patient’s anxiety about blood pressure and does not reflect the true state of blood pressure. In fact, it is sufficient to monitor blood pressure every day in the morning, in the afternoon, and at bedtime. Blood pressure fluctuates all the time, and 24-hour blood pressure monitoring helps to understand the peaks, valleys, averages, and day/night rhythms of blood pressure, which is important for evaluating cardiovascular risk, formulating treatment plans, and evaluating the effectiveness of medications, but it is also easy to trivialize this point. Patients mistakenly believe that increasing the frequency of self-measurement can achieve the effect of 24-hour blood pressure monitoring. Frequent measurements not only fail to reflect the real situation of blood pressure, but also add to the anxiety, and are not helpful to understand the nighttime blood pressure status. Inappropriate increase and excessive decrease of blood pressure at night will cause more damage to the body than daytime blood pressure, therefore, 24-hour blood pressure monitoring before and after taking medication is needed to realize fine blood pressure management. Step 3: Exploring the cause of the disease is indispensable 95% of the total hypertensive population has primary hypertension, i.e., hypertension with an unknown cause, and only 5% can find the cause of the disease, which is called secondary hypertension. However, the proportion of secondary hypertension in the young and middle-aged hypertensive population is as high as 40%, and nearly 20-30% of the refractory hypertensive population have primary aldosteronism. Therefore, it is necessary to conduct etiologic screening for young and middle-aged hypertensive patients at the time of the first diagnosis, with a focus on the renal and endocrine perspectives; and it is necessary to pay attention to the screening of refractory hypertensive patients for primary aldosteronism. Step 4: Risk Perception Awareness The risk of cardiovascular and cerebrovascular disease in patients varies with different blood pressure levels, the number of risk factors present, and comorbid organ damage and clinical disease. The purpose of assessing risk is to clarify the degree of risk, determine the optimal target value, and manage the patient as a whole in the context of the big picture, not just focusing on blood pressure per se in order to delay the first onset of cardiovascular disease and reduce the risk of disability and death. Risk assessment involves not only understanding lifestyle habits, identifying the presence of cardiovascular risk factors in the blood, but also determining whether there is damage to hypertensive target organs and whether there are any other clinical conditions. This process is cumbersome, but it is helpful to know enough to be able to judge one’s own health status. Step 5: Lifestyle Improvement Throughout The Causes of hypertension are not clear, but are related to poor lifestyles such as high salt intake, tobacco and alcohol stimulation, eating too much and moving too little, and emotional stimulation. One of the common misconceptions in treatment is the emphasis on medication rather than lifestyle changes. Nei Jing said, “the ancient man, its knower, the law in yin and yang, and in the art of counting, dietary discipline, living and living in a regular manner, do not make labor, so can form and God, and the end of its days, the degree of a hundred years old is to go.” Therefore, to defeat hypertension need to start from the daily living, eating habits, early change long-term persistence can be invincible. Step 6: Strive for Targeted Management Different measurement methods result in different blood pressure target values; different cardiovascular risks result in different blood pressure target values; therefore, it is important to pay attention to the differences in measurement methods and cardiovascular risks, to understand the target values, and to strive to achieve the optimal blood pressure target in order to minimize cardiovascular risks. The concept of differentiated target achievement due to measurement methods: blood pressure control in the clinic <140/90 mmHg or self-measurement at home <135/85 mmHg or 24-hour ambulatory blood pressure monitoring <135/85 mmHg during the daytime and <125/75 mmHg during the nighttime are considered to be in compliance with the target. The concept of differentiated attainment of cardiovascular risk: low-risk patients <140/90 mmHg and intermediate- and high-risk patients <130/80 mmHg are considered to be in attainment. The concept of standardization is not absolute, carotid artery stenosis, subclavian artery stenosis, patients with blood-stealing syndrome and elderly patients should be analyzed on a case-by-case basis, and if necessary, appropriately increase the standardized value to avoid cerebral ischemia. Step 7: Strengthen the awareness of follow-up Hypertensive patients often focus on prescribing medication but not follow-up, thinking that all is well if they take medication, and not paying enough attention to whether their blood pressure is under good control or not. Precise treatment of hypertension not only requires the selection of appropriate antihypertensive drugs with organ-protective effects according to individualized pathogenesis, but also the pursuit of optimal drug dosage and optimal time of administration, so as to strive for the achievement of the blood pressure standard at all times and continuously, and to overcome hypertension one step at a time!