How often to test?

I have recently been told I have cardiomyopathy and left ventricle bundle branch block caused by severe hypertension.  At the present time my EF is 40.  I had an echo and heart catherization 4 months ago.  My question is how often should tets such as an echo be repeated to see the progress of the cardiomyopathy?  Also, does this condition usually progress slowly if it is going to get worse or do things usually get worse quickly?  My blood pressure is still very high  (170/110)after 7 months of treatment. My internist says as long as it is not as high as it was (240/130), the cardiomyopathy will not get worse.  Is this true?  I have shortness of breath and extreme fatigue and am worried the disease is getting worse,  When do you think I should have another echo?  Thank you for your response.

[CCF CARDIO MD - DLB]

If your internist is managing your high blood pressure and cardiomyopathy, I would suggest a referal to a cardiologist. Whie it is true that your current blood pressure is an improvement, it is definitely not enough of an improvement to halt your cardiomyopathy. You also need an evaluation by a specialist in high blood pressure to figure out why your blood pressure is so elevated - this is important, as important as just treating you with medicines. If your blood pressure does not get under better control over the next few months, the cardiomyopathy will likely worsen over time (slowly, usually). Repeating the echo is less important than monitoring your blood pressure and symptoms for improvement.