Chest tightness is a common symptom in patients with hypertension, and it is easy to attract the attention of physicians and the nervousness of family members. This is because people are particularly likely to associate it with a lack of blood supply to the heart, i.e. an angina attack. The diagnosis of chest tightness and shortness of breath is both complex and important, and it is important to seek timely diagnosis and treatment from a physician. If the physician rules out heart disease, the patient should live and work happily with peace of mind. What is the cause of chest tightness in hypertension? As mentioned above, elevated blood pressure itself can appear chest tightness, which is characterized by chest tightness and the relationship between the time of elevated blood pressure is relatively obvious, such as the peak of blood pressure fluctuations in the afternoon when the patient appears symptoms, in addition to a long duration, not aggravated after the activity, no chest pain, do electrocardiogram or exercise electrocardiogram without ischemic changes, as blood pressure is controlled chest tightness symptoms also disappeared. Hypertensive patients with cardiac insufficiency can also have chest tightness, which is manifested as exertional shortness of breath without chest pain, and echocardiography will reveal abnormal systolic and diastolic functions of the patient’s heart, and the patient’s symptoms will disappear with the control of blood pressure and appropriate drugs to improve cardiac function. Of course, hypertensive patients with insufficient blood supply to the heart may have chest tightness and shortness of breath, and such symptoms are closely related to exertion, night sleep or early morning wake-up, and disappear when rested for 10-15 minutes; these patients have typical angina pectoris, and the symptoms can only disappear when treated with a combination of anti-hypertensive drugs and drugs to improve blood supply to the heart. In these patients, abnormal ECG can be detected by plate exercise test, isotope myocardial imaging can detect cardiac ischemia, and coronary angiography can determine the site and degree of lesion, providing sufficient scientific basis for further treatment.