Primary hypertension requires long-term medication treatment. In recent years, as clinical research continues to advance and European and American hypertension guidelines are updated, blood pressure management is regulated according to guidelines in addition to the use of 5 major classes of antihypertensive drugs, lifestyle improvement also plays an important role in blood pressure management, such as smoking and alcohol cessation, low-salt diet, and regular exercise, all of which are means to lower blood pressure. Geriatric hypertension is a complex group, mostly combined with various different diseases (coronary artery disease, cerebral infarction, renal insufficiency, diabetes, etc.), and evidence-based studies also tend to exclude these elderly patients. Despite appropriate treatment according to guidelines, some complex clinical presentations leave clinicians at their wits’ end. For example, patients have the typical morning peak phenomenon of hypertension (morning hypertension) and postprandial hypotension (a drop in blood pressure after eating breakfast, and patients experience dizziness and weakness. There are also some elderly patients who have frequent nocturnal urination and always get up 3-5 times a night, which seriously affects their sleep. There are also many elderly patients whose blood pressure presents as nocturnal hypertension, accompanied by dizziness, insomnia, and weakness of the lower limbs. These clinical problems cannot be solved by using Western medicine alone. The use of TCM diagnosis and treatment and the administration of herbal medicine can relieve the suffering of most elderly patients. Postprandial hypotension, most of them belong to spleen deficiency and qi and blood deficiency in TCM. Nocturnal hypertension mostly belongs to deficiency of heart and kidney and deficiency of liver and kidney. Most frequent nocturnal urination belongs to deficiency of kidney-yang and lack of power to consolidate. Chinese medicine treatment not only relieves clinical symptoms, but also reduces blood pressure fluctuations and improves the quality of life of patients. The 21st century is the era of continuous differentiation of medical specialties and the era of continuous integration of clinical medicine, mastering the clinical skills of Chinese medicine and Western medicine to better serve patients and benefit mankind.