recently diagnosed with hypertension

[cg60]

I was diagnosed with hypertension 15 days ago.  I was first put on Lisinopril which after 10 days did not bring my blood pressure down.   At which point my doctor wanted to put me on Coreg CR.  I have asthma, and have been suffering somewhat from shortness of breath so I had concerns being put on a beta blocker.  So he put me on Norvasc.  I have been on that since May 29th.   My blood pressures are still running somewhat high at times.  The problem is the diastolic and the heart rate.  Earlier today it was 144/102 but at that point my heart rate was 73.  Some of my recent readings are 141/101 pulse of 104:  129/104 with a pulse of 90;  137/102 with a pulse of 102.  I have a couple of questions.  1)  is it a danger when the systolic minus the diastolic are less than 40 in difference?  2)  I did not get to see my physician but did see the PA...and I told her that there is a history of strokes  (dad, sister) in my family.  And told her that was a concern, is it?  She did not seem to think so.  My chest does not feel normal.  Could that be due to the changes with the hypertension and the medications?  I did make an appointment with a cardiologist, but it is not until the 10th.  Thanks for your time, Concerned

[cg60]

I went back to my doctor's office today and the PA  doubled my dose of Norvasc.  Now I am on 10 mg daily.  My head feels weird, it is hard to describe the feeling....but that has been since all of this began.  This afternoon my BP was 136/105 with a pulse of 100.  She did give me the order sheet for a Thallium Stress Test, which is scheduled for the 10th of this month.  My BP is currently 117/89  with a pulse of 88.  Will the pulse pressure being less than 40 eventually cause me problems?  You talked to me about a diuretic.... my weight has stayed pretty consistent, bouncing between 148 and 152.  My lungs are clear.  So why the diuretic...?   And in your previous answer you said to have a stress test after the BP is controlled.  Should I change that date, since evidently it is not controlled at this point?  

[Douglas Bogart, MD]

Your blood pressure goal should be 130/80 or less.  A pulse pressure(systolic-diastolic) of less than 40 generally means the diastolic BP is high.  You may need a diurectic like chlorthalidone and you should ask the doctor about this.  Likely after your BP is controlled you will need a stress test.