With more and more contact with hypertensive patients, there are often some interesting points raised by patients, such as “It’s fine if you don’t use antihypertensive medication, but once you use it, you can’t get rid of it”, “How long do I have to take the medication for hypertension before it will stop?” “I can stop taking antihypertensive medication after using blood pressure lowering device” “I am anemic, how can I get high blood pressure?” “What kind of antihypertensive medicine is best?” And so on. Over time, we have found that many hypertensive patients have similar questions in their hearts and minds, and it is not painful to not understand them. Here, we might as well summarize these common interesting points and analyze them carefully to see whether they are reasonable. First, can hypertension be cured? Hypertension can be divided into secondary hypertension and primary hypertension. Secondary hypertension refers to hypertension caused by kidney disease, renal artery stenosis, adrenal tumor, etc. Some of these hypertension can be normalized by dealing with the underlying disease, for example, renal artery stenosis can be eliminated by placing a stent in the narrowed blood vessel, and adrenal tumor can be removed surgically. After the underlying disease is removed, blood pressure will drop to normal. However, there are not many patients with this type of secondary hypertension, and more of the hypertension (more than 95%) is primary hypertension, which is what we usually refer to as primary hypertension. This type of hypertension is caused by a combination of factors, rather than any one individual cause. Once this type of hypertension occurs, it cannot be completely eradicated in most cases unless strict lifestyle changes are made. Radiofrequency ablation of the renal sympathetic nerve, which has been explored in recent years for severe and intractable hypertension, seems to have a positive effect on lowering blood pressure and may provide a surgical method to “cure” hypertension in the future, but So far, there is no sure cure for essential hypertension with a single drug or means. Therefore, long-term lifestyle adjustments and effective antihypertensive medications are needed. Here we have to mention those who blow the mysterious “antihypertensive recipe” “antihypertensive device”, these products almost all boast that they can cure hypertension, is there really such a miracle? If there is, there is still a need for so many people in the medical and pharmacy fields to work hard for hypertension? The facts are clear, those are just money tricks. One of the author’s old patients stopped taking antihypertensive drugs because he believed in the magic of the “antihypertensive device” and had a stroke as a result. Second, the antihypertensive drugs will be dependent? Many patients mistakenly believe that once they start taking blood pressure lowering drugs, they will become dependent on them and have to take them for the rest of their lives. I have heard some patients describe the feeling of worry to me as if they are worried about drug dependence. Is this really the case? No, absolutely not. All blood pressure medications do not make a person dependent on them, and it is not the blood pressure that becomes dependent on them. The reason why lifelong medication is needed is because primary hypertension, as explained in the first article, is generally difficult to cure, and if medication is not used to lower blood pressure, then blood pressure will remain at a high level for life, and this will continue to cause cardiovascular and cerebrovascular damage. In order to lower blood pressure and reduce the risk of cardiovascular damage, it is necessary to take medication for life to continuously control blood pressure. Therefore, it is not the blood pressure or the person who will become dependent on the medication, but the high blood pressure itself needs to be controlled with medication for life. So, once you have high blood pressure and still can’t return to normal through lifestyle adjustments, then, boldly choose antihypertensive drugs because, that is what is needed to lower blood pressure. Third, is there a best antihypertensive drug? At present, there are six major classes of drugs used to lower blood pressure, and there are many varieties. The antihypertensive mechanism of each class of drugs is different, and so are the side effects; different varieties of the same class of drugs also differ in their antihypertensive strength and duration. Because hypertension itself is caused by a variety of factors and mechanisms, it requires the combined application of multiple classes of drugs to achieve good antihypertensive effects. It is very interesting that the combination of different classes of drugs not only enhances the effect of lowering blood pressure, but also counteracts or diminishes the side effects of each other. In addition, the causes of hypertension are not identical in different people, and other physiological indicators of the body are also different and respond differently to drugs. Therefore, for the selection of hypertension drugs, it is generally recommended to combine drugs, use medium and long-acting drugs as much as possible (that is, once a day, which is conducive to blood pressure stability), and emphasize individualization (that is, choose different drugs according to different individuals’ different physical conditions and antihypertensive reactions); in general, it is not possible to talk about which antihypertensive drug is the best, for a specific patient, as long as a certain drug regimen can steadily lower In general, it is not possible to say which antihypertensive drug is the best, as long as a certain drug regimen can steadily lower blood pressure and does not lead to obvious side effects, it is a good drug regimen for him or her. Fourth, does anemia prevent hypertension? Is there a relationship between anemia and blood pressure? Let’s use a less appropriate analogy and think of human blood as a grainy orange drink. Anemia refers to a lower than normal level of hemoglobin in the blood, just like a grainy orange drink with too few grains of orange flesh, which does not meet the standard requirements. The high blood pressure refers to the pressure caused by the blood flowing in the arterial blood vessels, just like the pressure caused by the drink rushing into the bottle when filling the grainy orange, which has nothing to do with the amount of orange meat particles. Therefore, anemia is not related to hypertension. Unless it is acute anemia caused by acute hemorrhage, that may be accompanied by low blood pressure or even shock, but that is also not caused by anemia natively, but by overall loss of blood. Therefore, people with anemia can still have high blood pressure. Fifth, there is no need to take medicine for high blood pressure without discomfort? Some patients often ask, “If you don’t feel uncomfortable when your blood pressure is high, but you feel uncomfortable when you take antihypertensive medication, does that mean you don’t need to take medication for such high blood pressure? The answer is: No! Most high blood pressure does not cause significant discomfort because the human blood vessels do have a strong ability to regulate blood flow according to blood pressure. However, as long as the blood pressure continues to operate at a high level, then the damage to the blood vessels, to the heart, brain, kidneys and other target organs is continuing to progress and sooner or later will cause major problems, even catastrophic consequences. Therefore, regardless of whether there is discomfort, as long as the blood pressure is high and cannot be restored to normal levels through lifestyle adjustments, you should take antihypertensive drugs, as for the discomfort of taking drugs, you need to analyze the specific situation, adjust the drug regimen and find the right drug. There are many other seemingly reasonable, but actually unreasonable views, most of which are caused by a lack of understanding of hypertension, concerns about drug side effects and other factors, and it is recommended that patients with hypertension discuss more boldly with a professional cardiovascular physician. The most taboo is to easily believe in all kinds of word-of-mouth gossip, fear of medication or random drug changes, stopping medication, that often brings some avoidable adverse consequences.