Familiarity with the adverse effects of commonly used medications can help community physicians improve the quality of hypertension management. For example, B-blockers can slow down the heart rate and have some negative inotropic effects. Excessive doses can cause bradycardia, hypotension and increased symptoms of heart failure, and a few patients may experience depression, fatigue and sexual dysfunction. Patients with cardiac insufficiency should start with a small dose and increase the dose every 2 weeks or so, while patients are advised to pay attention to any increase in shortness of breath. Non-selective B-blockers (propranolol) can also cause bronchospasm and peripheral circulatory disturbances, but are now less commonly used. Non-dihydropyridine calcium antagonists (verapamil, diltiazem) have strong negative inotropic and hypotensive effects, and should be avoided in combination with B-blockers, otherwise they may cause severe slow arrhythmias, and these drugs are rarely used to lower blood pressure. The use of dihydropyridine calcium antagonists (nifedipine, felodipine), although less cardiac depression, can cause edema and constipation in the elderly. ACEI and ARB can reduce glomerular perfusion pressure, so it is prohibited in patients with bilateral renal artery stenosis and severe renal insufficiency. ACEI to cough adverse reactions are well known to the clinic. Long-term application of diuretics is likely to cause hypokalemia, and excessive diuresis in patients with chronic renal insufficiency may aggravate the deterioration of renal function. Spironolactone has also been associated with gynecomastia.