When high blood pressure does not come down, it is likely to be intractable or refractory hypertension. In such patients, the first step is to identify the cause of the failure to lower blood pressure. Some patients may have insulin resistance, and it is necessary to increase the use of insulin sensitizers along with antihypertensive drugs to better control blood pressure. Pseudo-refractory hypertension, such as incorrect blood pressure measurement or overly severe atherosclerosis in the elderly. Some patients, although taking antihypertensive drugs, but the choice of antihypertensive drugs is not reasonable, it is necessary to change the antihypertensive drugs. Some patients, although taking antihypertensive drugs, do not pay attention to lifestyle improvement, still smoke, drink alcohol, do not pay attention to low-salt and low-fat diet, and do not lose weight. It is necessary to improve more from lifestyle and diet in order to better reduce blood pressure. Patients with grade 3 or higher hypertension have a diuretic component when choosing antihypertensive drugs. For patients with high blood pressure, it is important to find out if they are applying drugs that can trigger an increase in blood pressure, such as hormones, and recombinant human erythropoietin. If these drugs are used, try to reduce or stop their use. In some patients, blood pressure may be elevated due to secondary causes, such as renal vascular stenosis and primary aldosteronism, which should be treated for the primary cause to better control blood pressure.