After a decade of waiting, JNC8 was finally published in 2014. Because of its use of the findings of RCT studies published from 1996-2006 as the key basis for recommendations and suggestions, it was decided that the greatest highlight and fatal flaw of this edition of the guideline coexisted. Unlike the 2013 European version of hypertension prevention and treatment guidelines, JNC8 only recommends thiazide diuretics, angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and calcium channel blockers (CCB) as first-line antihypertensive drugs, and no longer recommends beta-blockers (BB) for the initial treatment of hypertensive patients. The author questions the clinical value of these recommendations in the field of hypertension prevention and treatment in China in at least five ways. First, in terms of the mechanism of hypertension: the development of hypertension is associated with four basic mechanisms, including increased activity of the sympathetic nervous system (SAS) and renin-angiotensin-aldosterone system (RAAS), increased vascular tone, and increased volume load. The mechanism of hypertension in the European and American populations is more associated with RAAS hyperexcitability (except in blacks), whereas this mechanism of occurrence in the Chinese population accounts for only about 20% and is more associated with SAS hyperexcitability. there are four main mechanisms of BB hypotension. ① blocking cardiac β1 receptors: slowing down heart rate, weakening myocardial contraction, reducing cardiac output, thus reducing venous return and blood volume and lowering blood pressure; ② blocking β1 receptors in the kidney: reducing RAAS activity, diastolic blood vessels, lowering peripheral vascular resistance and lowering blood pressure; ③ acting directly on β receptors in the central nervous system: weakening their excitatory neuronal activity, reducing the efference of sympathetic impulses (ii) blocking β1 receptors on the presynaptic membrane, reducing norepinephrine (NA) release and lowering blood pressure; (iii) reestablishing the sensitivity of pressure receptors: weakening the pressure-increasing effect of catecholamines during exercise or stress, increasing the level of vasodilatory substances such as prostacyclin in vascular tissues, and lowering blood pressure. Second, from the conclusion of the RCT study: the preceding well-known MAPHY study showed a 22% reduction in overall mortality, a 24% reduction in coronary events, and a 27% reduction in cardiovascular mortality in the group receiving metoprolol. JNC8 made its recommendation based only on the results of the LIFE study (comparison of BB and ARB, which was worse than the latter in the composite endpoint of cardiovascular disease death, heart attack and stroke). The above recommendation is too hasty. It is well known that the BB used in the LIFE study was a water-soluble atenolol, which has long been shown to be non-cardioprotective and is not representative of all BBs, and that different pro-solubility, intrinsic sympathomimetic activity, and metabolic pathways are key characteristics of BB safety and efficacy, and that different BBs need to be treated differently based on these characteristics and should not be confused. Metoprolol is fat-soluble, has no intrinsic activity and is metabolized by the special metabolic pathway of CYP2D6, which determines its antihypertensive and cardioprotective effects for sure and has very few drug interactions. Third, from the viewpoint of target organ protection: hypertensive patients are prone to the combined presence of coronary heart disease, heart failure, tachyarrhythmia, stroke, chronic kidney disease, etc. BB is the key drug for the prevention and treatment of the above target organ damage complications, and even the only drug that may improve long-term prognosis in the prevention and treatment of some complications. Fourth, from the perspective of blood pressure control standard: many young patients with hypertension, hypertension in the early stage, hypertension combined with sympathetic excitation symptoms (increased heart rate, more sweating, emotional irritability, etc.) or overweight, obese patients are mostly manifested as diastolic hypertension, BB is undoubtedly an important option for these patients to achieve blood pressure standard. The majority of these patients have “hyperdynamic hypertension,” which is high blood pressure due to increased heart rate, increased myocardial contractility, and consequently higher cardiac output. Studies have shown that the core mechanism of hypertension in this group of patients is increased beta-receptor responsiveness, and therefore BB is the most effective therapeutic agent. Finally, from the perspective of blood pressure control in special populations: based on the latest domestic and international guidelines, the first-line status of BB has never wavered for hypertension in pregnancy and hypertension combined with abnormal thyroid function. In conclusion, the important role of BB is irreplaceable and indispensable, both in terms of the mechanism of hypertension, blood pressure achievement and target organ protection and long-term prognosis improvement. Without BB, the prevention and control of hypertension and its target organ damage complications will definitely fail in all aspects without starting from the mechanism of hypertension development. Therefore, clinicians must correctly grasp the value of European and American guidelines for clinical guidance of Chinese patients in the real world. We firmly believe that in the near future, BB will return with a “king’s return” to highlight its unshakeable status.