In daily life, many hypertensive patients will ask their doctors – I am not fat, how can I get hypertension? In fact, what the people call hypertension is mainly primary hypertension, and its specific etiology is not yet clear. Current scientific research speculates that it may be related to the following factors: 1, sympathetic nerve activity is elevated for various reasons resulting in the disruption of the human body environment, stimulating the brain neural regulation out of control, resulting in renin, catecholamines abnormal release increased, causing blood pressure to rise. 2, RAAS activation renin-angiotensin-aldosterone pathway is an important metabolic pathway in the body, many factors can affect a link in it, causing abnormalities, resulting in increased blood pressure. 3, genetic polymorphism genetic polymorphism is manifested in different individual hypertension on receptors, metabolic enzymes, targets, etc. can have an impact, resulting in different drug metabolism, blood drug concentrations also exist significantly different, and therefore have an impact on the efficacy. 4, neurotransmitters in the human body can release different types of neuropeptides, such substances are vasoactive, disrupting the dynamic balance of the relationship in the body, triggering hypertension. 5, insulin resistance clinical studies have found that hypertensive patients are often accompanied by elevated insulin concentrations and insulin resistance. Hyperinsulinemia will increase the renal tubular Na+ re-entry, leading to the occurrence of water and sodium retention; enhance sympathetic nerve activity, increase the concentration of catecholamines in the blood, which has an impact on the transport of cation in the blood, increase the intracellular Ga2+ concentration, enhance vasoconstriction, and have an impact on vasodilatory function, which in turn raises blood pressure. 6, vascular endothelial dysfunction endothelial cells can regulate the diastolic effect of blood vessels, which is important to maintain the stability of blood vessels. 7, cell membrane ion transport abnormalities in the cell membrane sodium-potassium pump, calcium pump abnormalities, and ultimately lead to elevated sodium ions in the body, water-sodium retention, and increased blood pressure. 8, inflammatory response inflammatory response in the inflammatory factors such as C-reactive protein, interleukins, tumor necrosis factor and prostacyclin-like substances, nitric oxide and other balanced relationship between the disruption, resulting in increased blood pressure. That is why there are antihypertensive drugs that appear for the above possible mechanisms, such as diuretics, calcium antagonists, beta-blockers, ACEIs, ARB analogs, etc. Specifically for each hypertensive patient, the doctor will choose the appropriate antihypertensive drug to achieve good blood pressure control according to the patient’s specific condition. As science progresses and develops, there are more and more mechanism hypotheses to explain hypertension, and accordingly, more antihypertensive drugs will be created.