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

### input:
Hi. I am a thirty year old female. am a thirty year old female. I was diagnosed with primary hypertension at age 25. My average reading at diagnosis was 145/110, with peak reading at 185/120. In the past few years, my blood pressure readings have averaged out to slightly above normal with medications, averaging 125/95. However, yesterday I had a higher reading of 150/105 and earlier tonight my blood pressure spiked to 140/115 but has now dropped back down to 135/90. I was diagnosed with Type 2 diabetes at age 25 with a fasting blood sugar of 385. Now my blood sugar is in close to normal levels and is treated with Metformin and diet. My A1C is also in normal ranges. I was diagnosed with high cholesterol at age 26. At diagnosis, my total cholesterol was 310. Now it is down to 210 with medication and diet. At diagnois, my LDL cholesterol was 220 and has now dropped to 135 with medications. At diagnosis my HDL cholesterol was 75 and has now risen to 90 with my total cholesterol level being 210 at my last appointment with my cardiologist which was two weeks ago. I have been obese for most of my life and have been unable to lose much weight even with diet and exercise. At my heaviest, I weighed 285 pounds and am now down to 245 pounds which is about 110 pounds overweight. I take Metformin, Benicar, and Vytorin. Last night, I felt naseous and had waves of slight pain and pressure in my chest. I also felt pain in my jawline and left elbow area, whicChatDoctore and went in waves. I was sweating more than usual and was dizzy, but felt better with rest. Today I went about my normal routine, but felt dizzy when I went on my evening walk and now my left arm is numb. With my history, should I go to the ER just be sure this isn t cardiac related?

### output:

Hello, With the history what appears to me that your blood pressure is high of course what appears from the readings. But for now I feel it's not any heart attack for now. If it was then things would haven been complained as different way. As dizziness and sweating can also occur due to low blood glucose levels. Now coming back to the fluctuations in the readings. If you are taking the measurement from any of the digital machines, it can show errors too. Having it done on a traditional Blood Pressure apparatus called sphygmomanometer is advised. Next your blood pressure was high, but which arms that you did not mention? Left or the right? Considering the higher on the left or the right the medication will be advised. Coming to your diabetic profile. Usually, due to sedentary lifestyle, people tend to develop the early high blood glucose levels. Taking part in a regular physical activity like exercise should help it under control without having taking medications on a longer run. For high cholesterol levels this has to be taken care with diet more and exercises equally. As cholesterol levels are increased in most cases because the type of food one eats and doesn't burn out leading to high levels. Avoiding oil completely should definitely give the results in reducing the cholesterol levels. Now your next problem is obesity. Now this is something which definitely needs exercise and diet plan. In my clinical practice of 12 years I have seen cases with obesity, high blood pressure, high cholesterol levels and high blood glucose levels at early ages, but all responded well to diet and exercise well and now all are healthy.  Medicine is of course good but on long run not good for body and especially kidneys. So most doctors advice control of the symptoms mentioned above with diet and exercise. I hope that you start the diet and exercise regime sooner so that you get some excellent results. 30 is not the age to visit medical professionals more often. This is the age to enjoy. Hope I have answered your query. Let me know if I can assist you further. Jay In Chat Doctor. 