For a long time, the treatment of hypertension has followed the biomedical model, emphasizing that hypertension is a metabolic syndrome that requires various means such as medication, diet control, and weight control to keep blood pressure within a reasonable range. However, after long-term medication and diet control, why do so many patients still have poor blood pressure control and develop persistent hypertension? Why is the incidence of myocardial infarction still not reduced? Perhaps, the answer can be found in another medical model, the psycho-biological-social medical model. In the psychosocial-biological-psychological medicine model, the concept of psychosomatic diseases emerges. A psychosomatic disease is a physical disease in which psychosocial factors are involved in the pathogenesis as an important cause, and hypertension is a psychosomatic disease. Elevated blood pressure is a somatic manifestation of depression and anxiety Sudden changes in social and environmental factors, especially the occurrence of unpleasant social events or emergencies, tend to cause emotional stress and lead to elevated hypertension. During World War II, the prevalence of hypertension rose from 4% before the war to 64% among those who were besieged in the former Soviet city of Leningrad for three years. People in the city dealt with fatigue bombing all day, waiting for death notices from loved ones, waiting for enlistment notices, no food, and power and water outages. People were in a chronic state of anxiety and depression, and the incidence of hypertension increased dramatically. Not only people, but also animals can suffer from hypertension if they are under a prolonged state of emergency. Friedman’s sensitive rat blood pressure test showed that if white rats were subjected to electric shocks (or a stressful situation caused by a beating) while taking food, they could develop elevated blood pressure as a result. In a study of consecutive patients attending a cardiology clinic, the prevalence of anxiety was 42.5% and depression was 7.1% in 3260 cases; in hypertensive patients, the prevalence of depression was 4.9% and anxiety 47.2%, and the prevalence of hypertension was twice as high in depressed and anxious people as in normal people. The biological mechanism of blood pressure elevation caused by mood disorders: when fear and anxiety are present, there is a relative increase in adrenaline secretion and a significant increase in systolic blood pressure due to increased cardiac output, accompanied by increased skin and electromyographic values; when anger and hostility are present, the concentration of norepinephrine in the blood rises and peripheral vascular resistance increases, then diastolic blood pressure increases predominantly, and skin resistance and potentials are also increased. When hypertensive patients are accompanied by psychological disorders, a combination of antidepressant and anxiety medications as well as hypertension-lowering drugs is required. Many patients who have been treated with multiple combination antihypertensive drugs for poorly controlled blood pressure with psychological disorders can have better control of their blood pressure immediately after treatment with an antidepressant drug. However, the medical community is still not aware of this, 80% of patients with psychosomatic disorders seen in general hospitals, 60% to 80% of them are missed and mistreated. Many internal medicine doctors still have limitations in this understanding. Some hypertensive patients are also very uncooperative with psychological treatment by physicians, firstly, they are shy about the term psychological disorder and resist to be consulted by physicians about their emotional problems; secondly, they are concerned about the side effects of antidepressants. Therefore, the diagnosis and treatment of mood disorders in hypertension should be given enough attention. In this issue, we will introduce the clinical manifestations of hypertension with psychological disorders with actual cases to help people gain a new understanding of this problem, which may be able to answer the confusion of some patients why hypertension is not cured for a long time.