Conversation: The conversation between human and AI assistant.
[|Human|] HiI am a heathy 42 year old woman who have suffered with very high blood pressure for the pass three years....my highest being 249/189 .....I am on medication but nothing seems to work....my doctor keeps telling me that we need to bring it down but nothing works...I have been admitted to hospital a few times but yet again everything that they suggestion or new meds that I have been put on do not work.....my last reading today was 190/121......any suggestions?
[|AI|]  Hello! Welcome and thank you for asking on Chat Doctor! I understand your concern and would explain that your symptoms are indicative of a secondary hypertension. At your age, these values of high blood pressure may be related to a secondary problem (metabolic disorder, kidney impairment, etc.). At this point the most important thing to do would be to investigate for the possible cause of uncontrolled high blood pressure. So I recommend consulting with your GP for a careful physical examination, a resting ECG, a chest X-ray study, an abdominal ultrasound and some blood lab tests : -complete blood count-PCR, sedimentation rate (inflammation)-kidney and liver function tests-thyroid hormone levels-blood electrolytes-fasting glucose-cotisol and aldosterone plasma levels (a Chat Doctor.  The levels of metanephrines in your 24 hours collected urine may be needed to investigate for possible pheochromocytoma. Hope to have been helpful! Best wishes!