Poor lifestyle, irrational use of medication, new onset of secondary hypertension, and sympathetic over-activation may be the main causes of persistently high blood pressure that does not come down. The condition that blood pressure stays high but does not come down based on correct measurement of blood pressure is clinically known as refractory hypertension. When you use a combination of three kinds of antihypertensive drugs in the right dose and with reasonable treatment (including diuretics); hypertensive patients whose blood pressure still can not reach the standard is called refractory hypertension; and with ≥ 4 kinds of antihypertensive drugs blood pressure can reach the standard, called controllable refractory hypertension; with ≥ 5 kinds of antihypertensive drugs blood pressure still can not reach the standard of hypertensive patients, called intractable hypertension. 1, bad lifestyle: modern society, the pace of life, work accelerated, life is relatively rich, to a certain extent, prompted people to develop a lot of bad habits, and take it for granted. Such as high sugar, high fat, high salt diet, insulin resistance or uncontrolled diabetes, addiction to smoking and alcohol, overweight or obesity, sedentary, long-term stay up late, sustained high stress state, etc., can lead to increased blood pressure, difficult to control. 2, unreasonable medication: hypertension patients do not take their medication regularly, the slow-release or control dose of drugs broken open, chewed to take, medium- and short-acting drugs failed to strictly in accordance with the time requirements, may lead to blood pressure can not be lowered. In addition, some drugs have the effect of raising blood pressure, such as glucocorticoids, anti-anxiety and antidepressants, certain weight loss drugs, recombinant human erythropoietin, cyclosporine, etc. 3, new secondary hypertension: in the original blood pressure is normal or blood pressure is stable, regular medication, good lifestyle, the recent emergence of a sustained increase in blood pressure, must promptly seek medical advice, need to investigate whether there is a new secondary hypertension cause. If the cause of secondary hypertension persists, it will lead to paroxysmal or persistent elevation of blood pressure, and conventional antihypertensive treatment is ineffective or less effective. 4, neurogenic factors may be related to persistent elevation of blood pressure: In patients with persistent elevation of blood pressure, it is often found that most patients have a fast mean heart rate. Increased sympathetic nerve activity in humans causes increased heart rate, increased beat-to-beat blood volume, increased peripheral vascular resistance, and increased blood pressure, and may lead to failure of conventional antihypertensive therapy. Factors that can cause increased sympathetic activity include smoking, alcohol consumption, obesity, late nights, stress, sleep apnea and some disease factors. Sustained elevation of blood pressure can cause serious damage to target organs such as the heart, brain and kidneys, and requires great attention to find the cause and treat the specific cause.