<s>[INST] Hello doctor,My blood pressure is 150/90 mmHg and my age is 18 years and there is a pain in the neck and at the top of the head. Please help me. Currently, I am taking Arbitel 250. [/INST] Hi. I noticed that you have grade 1 obesity (attachment removed to protect patient identity). You will need to give more history, for example, do you have a family history of hypertension. The neck swelling needs to be evaluated to rule out a thyrotoxicosis. 1.Urinalysis. 2.Serum electrolyte urea and creatinine. 3.Fasting lipid profile. 4.Fasting blood glucose. 5.Chest radiograph. 6.Urine VMA (vanillylmandelic acid). 7.Neck scan. Rule out substance use disorder. Endocrine cause of hypertension. See a doctor to prescribe antihypertensives. 1.Reduce salt intake. 2.Lifestyle modifications like weight loss, exercise, alcohol reduction, smoking cessation. For more information consult a family physician online.---> </s>