There are many reasons for poor blood pressure control, and it is not always the case that the blood pressure lowering program needs to be adjusted. In the clinic often encounter such a class of patients, the reason for consultation is mostly poor blood pressure control, want to adjust the antihypertensive program, and even some patients are hospitalized for this examination to clarify the reasons for poor blood pressure control, for this class of patients, the following issues you may need to consider. 1, inaccurate blood pressure measurement Now many hypertensive patients have their own electronic sphygmomanometer at home to monitor their own blood pressure, which is a very good habit, but if the electronic sphygmomanometer is damaged, not corrected for a long time, or incorrect measurement methods and so on some cases, may appear high blood pressure, once this time to increase the dose of antihypertensive drugs, may lead to serious consequences. 2, poor compliance poor patient compliance is also the cause of blood pressure fluctuations, can not come down, some patients are busy, often forget to take drugs, or only when the symptoms of dizziness, headache, etc., part of the patient because of the fear of adverse drug reactions, drug resistance, of course, more elderly patients, due to the combination of coronary heart disease, diabetes and various other diseases, need to take daily Close to 10 kinds of drugs, the elderly memory is poor, resulting in some antihypertensive drugs forget to take. 3, taking drugs that affect blood pressure Some clinical drugs can lead to an increase in blood pressure, such as glucocorticoids, non-steroidal anti-inflammatory drugs can lead to sodium and water retention, oral contraceptives can cause vasoconstriction through the activity of the renin-angiotensin-aldosterone system, and stimulate the release of adrenocorticotropic hormone causing a further increase in blood pressure, and licorice in traditional Chinese medicine can also lead to an increase in blood pressure that It becomes difficult to control. 4, serious bad lifestyle bad lifestyle we all more or less will have some, but some of the following conditions may have a great impact on your blood pressure, long-term high salt intake, extreme anxiety, a lot of smoking, heavy obesity, chronic pain, especially when the above-mentioned conditions combined with a number of, more likely to appear significantly higher blood pressure. 5, the use of antihypertensive drugs mainly includes two aspects of the problem, the first is whether the dosage of drugs is sufficient, if only the minimum dose is used, it is understandable that some patients have poor blood pressure control; the second is whether the right choice of drugs, for patients with high sympathetic activity more ACEI or ARB drugs, and Β-blockers, for patients with a lot of salt intake, you can use Diuretics plus CCB class, if the blood pressure is still not well controlled, colistin and some other central antihypertensive drugs can also be considered. 6, pay attention to secondary hypertension If the above cases are not considered, it is necessary to exclude whether it is secondary hypertension, secondary hypertension only for the primary cause of treatment to really good blood pressure control, the current common causes of secondary hypertension include: sleep apnea hypoventilation syndrome, primary aldosteronism, renal parenchymal hypertension, renal vascular hypertension, pheochromocytoma . The diagnosis of each of these diseases will not be described. All of the above causes can lead to difficulty in controlling the patient’s blood pressure. As clinicians, we need to have a wise mind like Sherlock Holmes, not to overlook some details and find out those culprits that lead to elevated blood pressure.