Many hypertensive patients believe that they cannot take oral antihypertensive medication because once they take oral antihypertensive medication, they have to take it for life and form “dependence”. So when do hypertensive patients need oral antihypertensive drugs? Once taken orally, should they be taken for life? First, we need to understand the classification of hypertension. Hypertension is divided into two categories according to the cause: one is primary hypertension, and the other is secondary hypertension. Secondary hypertension can often be found in diseases that cause elevated blood pressure, such as pheochromocytoma, adrenal occupancy, renal vascular stenosis, and primary aldosteronism. If the secondary disease can be removed, blood pressure can often return to normal. For example, if a patient has renal artery stenosis, blood pressure can return to normal after the stenosis is removed, and oral medication is no longer needed. This is why when hypertension is first diagnosed, doctors perform renal ultrasound and renal vascular ultrasound in order to exclude secondary diseases. If no specific disease can be found that causes elevated blood pressure, then we consider primary hypertension. It is currently believed that the cause of primary hypertension is the result of the interaction of genetic and environmental factors. Primary hypertension requires antihypertensive drugs once a certain blood pressure level is reached. Currently, China’s hypertension is defined as high pressure ≥ 140mmHg and/or low pressure ≥ 90mmHg. For patients with high pressure between 140-159mmHg and low pressure between 90-99mmHg, they belong to hypertension level 1 and can first improve their lifestyle without taking antihypertensive drugs immediately. Improving lifestyle includes: low salt and low fat diet, moderate exercise, quit smoking and alcohol, control weight, and maintain good mood. It is possible that blood pressure can be improved by improving the lifestyle for a period of time. In contrast, patients with blood pressure of high pressure ≥ 160 mmHg and/or low pressure ≥ 100 mmHg, which have reached or exceeded the level of grade 2 hypertension, need to start oral antihypertensive drug therapy. Five major classes of drugs are commonly used: calcium antagonists, beta-blockers, ACEI class, ARB class, and thiazide diuretics. According to the blood pressure, the dose of antihypertensive drugs is gradually adjusted to maintain the blood pressure in a stable and appropriate range. This group of patients is required to take oral antihypertensive drugs for life. Therefore, if you notice an increase in blood pressure, it is recommended that you visit a hospital promptly for a thorough examination to exclude secondary diseases. If the diagnosis of primary hypertension is made and the grade is 2 or higher, lifelong oral antihypertensive medication is required. If blood pressure is not effectively controlled, it is very harmful to cardiovascular and cerebrovascular and systemic small arteries, which can form a variety of complications and seriously affect the quality of life.