Patient: Description of condition (onset, main symptoms, hospital visited, etc.): I, male , 39 years old, teacher. Height 165, weight 61KG. Both parents are hypertensive and both started taking medication to lower their blood pressure in their 40s. I was diagnosed with hypertension in April 2008 in a second-tier hospital and started taking medication. Usually, blood pressure is generally stable. Recently, due to the death of my older brother, I have been having a hard time and my blood pressure has become less stable. Normally, my blood pressure is usually below 110/75, but every few days, it rises, usually between 14:30 and 22:30, with each attack lasting a minute to a few minutes. After a few minutes, the blood pressure returns to a level of about 110/80. During the attack, the person is agitated and dizzy. I got hypertension in April 08 due to stressful work and hard work. The highest blood pressure at the time of discovery was 160/130, with headache and palpitations. At the outpatient clinic of the local second-tier hospital, he took Lodinexin and diuretics. Two months later, blood pressure gradually normalized. Due to severe coughing on Lodinexin, he was later changed to Zhenju antihypertensive medicine three times a day. In January 09, he was admitted to a second-tier hospital for 15 days with dizziness, palpitations and high blood pressure (140/100). He was treated for cerebral blood supply deficiency as the main symptom, and was hooked up to blood vessel expansion drugs and blood stasis activators. After discharge from the hospital, he was very weak and walked with weak legs. After discharge from the hospital, I took Dextran (80 mg) and felodipine (2.5 mg*2) to lower blood pressure, and Cipro and a blood-boosting herb from Changchun, Jilin to relieve cerebral insufficiency. Blood pressure is stable, often measured around 110/80. However, the problem of dizziness and chest tightness persisted. In June 2010, when my brother died, I had a hard time and my blood pressure started to become unstable. It peaked at 180/110 and was measured in an air-conditioned room, after long hours in bed watching TV, when I was having a hard time. The same situation occurred twice. After ultrasound of kidney, liver and cervical artery, myocardial enzyme profile, electrolyte measurement, thyroid series, urine routine, blood cell analysis, lipid analysis, kidney function, liver function and other blood tests, cervical thoracic film, CT of chest and kidney, there were no other problems except for low HDL. The results of the four tests for hypertension (prone) were as follows: aldosterone 171.83ng/l (reference value 59.5~173.9) angiotensin 1 1.71ng/l (reference value 0.35~2.95) plasma renin activity 1.55ng/l/n (reference value 0.05~0.79) high angiotensin 2 63.65ng/l (reference value 28.2~52.2) 52.2) Due to high renin, CT of kidney and adrenal gland was done and no problem was found. On July 10, after discharge from the hospital, took and sartan (80 mg, 6:30 am) and felodipine (2.5 mg, half capsule, 2:30 pm). Blood pressure is basically under control, usually below 105/75. But it is the blood pressure will be a little high from time to time, especially when people are nervous and more likely to attack. During the attack, it was 150/100 when it was high and usually went to about 135/90. During the attack, the person was obviously uncomfortable, irritable and panicky, but the blood pressure went down in a few minutes and returned to below 110/80. For more than two years, even when my blood pressure was stable, my dizziness and chest tightness were always present, but not very severe. During this period of time, the dizziness and chest tightness, the feeling of discomfort in the precordial area increased significantly, and people were more anxious. The doctor prescribed Dextran, but I haven’t taken it because I think I can adjust my mind through positive psychological suggestion, and because I am afraid of dependence on the medicine. Can I rule out secondary hypertension with these symptoms? Tao Bo, Department of Cardiology, Shanghai Ruijin Hospital: You are so careful! As expected of a teacher! According to my experience, primary hypertension is very likely, there is not much advice on medication, only that Delixin is not recommended to eat, but anxiety is present, not more than three months self-regulation can try. Sleep is also not very good, right? The first thing to do is to start with improving your sleep, which is not dangerous.