Case: Ms. Liu is 50 years old. For a year, she would suddenly experience dizziness and headache at home, and her blood pressure could be as high as 170/90 mmHg on self-test. Therefore, she has been taking temporary medication for a long time to cope with the occasional increase in blood pressure. A few days ago, Ms. Liu was admitted to the hospital because she had a crooked mouth and was unable to move half of her body. There are many cases similar to Ms. Liu’s temporary medication. These homes are equipped with electronic blood pressure monitor, measured blood pressure high on a piece of (mostly short-acting, rapid antihypertensive drugs), blood pressure down, people do not feel uncomfortable, busy, lazy, regardless. I do not know, treat the treatment of hypertension, take the above-mentioned approach is very dangerous. The cause of hypertension is not well understood, and it is generally believed that it involves genetic, neurological, endocrine, humoral, cardiovascular system and many other aspects; diet, living habits, surrounding environment and other influences can also become the cause of the increase in blood pressure. The ultimate goal is to prevent damage to the heart, brain, kidneys and other major organs and to prevent accidents. The importance of steady blood pressure lowering The importance of “steady blood pressure lowering” means that blood pressure should be kept at a relatively stable level. Studies have found that fluctuating blood pressure has a negative impact on the arteries and can easily cause endothelial damage, which is conducive to the formation of atherosclerosis. Therefore, for unstable blood pressure, even if the measured blood pressure is sometimes not very high, we should also take comprehensive preventive and control measures, should choose the appropriate antihypertensive drug therapy (such as long-acting or slow-controlled dosage form of antihypertensive drugs), do not advocate the frequent adoption of temporary taking fast, short-acting antihypertensive drugs. 3 major disciplines of stable antihypertensive 1, individualized treatment, rational use of drugs The six commonly used antihypertensive drugs such as diuretics, beta-blockers, calcium antagonists, a-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, can be selected as the beginning of antihypertensive drugs, that is, first-line antihypertensive drugs, due to the different characteristics of the action of various types of antihypertensive drugs, so the choice should be based on each hypertensive person’s The specific situation of each hypertensive person, such as the degree of hypertension, heart rate, whether accompanied by diabetes, urinary protein, coronary heart disease, myocardial infarction and heart failure, varies from person to person. Diuretics are the most commonly used first-line antihypertensive drugs for the elderly, hypertensive patients with renal failure or heart failure, and should be used with attention to potassium supplementation and may be detrimental to blood glucose. Beta-blocker antihypertensive drugs are especially suitable for patients who have had myocardial infarction, with angina pectoris, rapid heart rate or heart failure. Calcium antagonists (CCB) are indicated in the elderly and in hypertensive patients with angina pectoris. Common adverse effects are headache, facial flushing, and ankle edema. Angiotensin-converting enzyme inhibitor is indicated for patients with heart failure or myocardial infarction, patients with diabetic proteinuria, it has target organ protective effect, common adverse effects are dry cough. Angiotensin II receptor blockers are the latest class of antihypertensive drugs, which also have target organ protective effects in patients with heart failure, diabetes mellitus and renal impairment, and have few adverse effects. It is especially suitable for patients with adverse reactions to other antihypertensive drugs, and can significantly improve patients’ treatment compliance. Anti-hypertensive treatment should be smooth, long-term, continuous and regular, following the principle of “small dose, various drugs in combination”, which means that their effects are superimposed and side effects are offset. For example, in patients with proteinuria, we may choose ACEI or ARB drugs to reduce proteinuria, protect renal function and delay the process of renal insufficiency; in patients with hypertension accompanied by coronary artery disease, medication should be considered for cardiovascular protection, vasodilatation, endothelial protection, etc.; in acute Myocardial infarction and other hemodynamic instability, antihypertensive we advocate the use of short-acting antihypertensive drugs to adjust the dose in a timely manner, because at this time the patient’s blood pressure is already unstable, if long-acting drugs to eat may make blood pressure fluctuations difficult to adjust in a timely manner. 2, the use of drugs to achieve the standard control of blood pressure should be based on achieving the standard. Some patients have a clear diagnosis of hypertension, the medication may also be standardized, but the medication is not up to standard, that is, not the most rationalized individual treatment. The control of blood pressure varies from disease to disease, with different target values for different populations, for example: normotension is defined at <120/80 mm Hg; 120-139/80-90 mm Hg is defined as the normal high blood pressure level. In general, the target value of blood pressure reduction for hypertensive people is <140/90 mm Hg; for diabetic patients with hypertension <130/80 mm Hg; for hypertensive patients with impaired renal function with proteinuria <1 g/day the prescribed target blood pressure should be achieved, but also combined with the actual situation of each hypertensive patient, and never forced to achieve the target immediately regardless of the condition. Because hypertension is a chronic disease, blood pressure fluctuates slightly is a common phenomenon, should not strive to quickly and immediately lower the blood pressure to normal, can be adjusted according to the state of the patient's blood pressure medication program at any time. 3, frequent monitoring of blood pressure is very important Monitoring blood pressure there are two ways: one is their own home monitoring, the use of sphygmomanometer, pulse meter and other monitoring of blood pressure and heart rate; on the other hand, you can take the initiative to regularly consult a doctor, so that the medical staff to monitor blood pressure, and timely records. In general, hypertension physiologically has "two peaks and a valley", that is, a "morning peak" in the morning and another in the afternoon. We advocate monitoring once a day, either in the morning or in the afternoon, depending on each person's situation. We do not advocate taking blood pressure every hour or two because of monitoring, as this will increase the patient's psychological burden. If the blood pressure is high in the hospital, we recommend a 24-hour ambulatory blood pressure check to avoid "white coat hypertension". Non-pharmacological lifestyle interventions, i.e., good lifestyle habits, should be used throughout the treatment process. It is important to pay attention to a reasonable diet, control the daily sodium intake (less than 6 grams), appropriate activity, control weight to reduce obesity, quit smoking and alcohol, etc.