### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am a 45 year old female with a recent onset of high blood pressure, and a year long history of low vitamin D. I had recent blood work done to check my blood after starting a new blood pressure med hydrochoridzide(??) . My blood work is showing an elevated sugar 146, low potassium 3.3, low vitamin d (22) UP from 15 last year, and elevated liver enzymes. My PA wants to refer me to a gastroenterologist for the liver test results. ALT (181, AST (65), AP (185) . Can this be related to the meds she has me on for the blood pressure? I feel fine, other then my heart beating hard and profusely at the slightest bit of exertion like climbing stairs. The blood pressure is still hanging out in the 145-150/93-100 range so I don t think the meds are really working unless it is too soon to tell. I am 5 3 tall and weight around 145-150 lbs

### output:

Difficulty in climbing upstairs is medically termed as dyspnea on exertion(if breathing is heavy) or angina on exertion(if heaviness is observed in chest) though you say u just feel heart beating hard yet as you are hypertensive grade 2 diastolic even on medicines we need to rule out cardiac involvementhydochlorthiazide is a class of Chat Doctor. . Diuretcs causes side effects like electrolyte disbalance hyperglycemia (increased blood sugar) and deranged liver functions as you are grade 2 hypertensive to i would advise you to switch over total molar XR 25 mg twice daily tab amlodipine 2.5 mg once daily tab esprit av 75/20 mg once at night sachet Mayo k 60 k to be taken once for 4 weeks then once a month for 4 monthscbctmtand get a 2 d echo done to rule out cardiac involvement for difficulty in climbing stairs