Inappropriate application of antihypertensive drugs is the most common cause of primary recalcitrant hypertension. Misunderstandings in the application of antihypertensive drugs include irrationality in the initial selection of antihypertensive drugs. Initial diagnosis of hypertension patients should be detailed relevant auxiliary examination, accurate assessment of the functional status of each organ and the degree of damage to the target organ, and dynamic blood pressure monitoring should be done to accurately assess the level of blood pressure if possible. Before selecting antihypertensive drugs, the patient should accurately grasp the overall level of blood pressure, the history of previous use of drugs, the control of blood pressure after taking drugs, the emergence of drug side effects, the indications and contraindications of the proposed drugs, and also be familiar with the pharmacological mechanism of alternative antihypertensive drugs. Ultimately, based on the patient’s own physical condition and blood pressure level, the decision is made to select the antihypertensive drug that is expected to lower the patient’s blood pressure to the target level. Most of the poor results of drug therapy are due to insufficient knowledge of the pharmacological effects of antihypertensive drugs, lack of experience in the use of the selected antihypertensive drugs, lack of familiarity with their antihypertensive efficacy, and inability to rationally select the drugs. In addition, the lack of detailed inquiry about the patient’s medical history (including medication history) is also a common reason, resulting in the initial selection of antihypertensive drugs is unreasonable, affecting the effect of the subsequent combination of drugs.