<s>[INST] Blood pressure is 123/86 with a pulse of 109. 53 year old male. 74 kilos and live in warm part of Costa Rica. I m taking Ramipril, Hydrovhlorothiazide, amlodipne, cipralax and oxi-dine for knee pain. I am on a good diet and try to exercise daily.. I sleep more often now then before and have stopped smoking 11 days ago.mi was taking zyBan. But decided to stay off it. I have been suffering by hypertension for two years now and still find the need to monitor my pressure as it has increased to 150/110 without reason.. Await your reply [/INST] Hi, dairy have gone through your question. I can understand your concern. Your blood pressure is too high. You should immediately consult your doctor and take treatment for that. Life-threatening events like myocardial infarction or stroke can occur with this blood pressure. We can not find all the cause of blood pressure.  Genetics, lifestyle, stress and many other factors are there. You need to set the dosage of your antihypertensive medicine. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using Chat Doctor. Wish you a very good health. </s>