<s>[INST] Hello, Ive had hypertension for about 15 years, but usually under control with the meds Im taking. However, Ive had a moderate to severe headache for weeks, frequent dizziness, low urine volumes, fatigue and poor sleep. I dont normally keep track of my BP, idiotic as that may sound. But I saw my doctor last Thursday for these symptoms and my BP was 197/119, pulse 52. He added 5mg of amlodipine to my meds and said to monitor BP for a week. Im doing so every couple hours, but it is staying between 150-186 systolic and 94-110 diastolic, pulse 48-56. Should I consider going to the ER? [/INST] Hello, BP is high, here I would add further medicine like tab Telmisartan or dose of Amlodipine would have increased to 10 mg.  You should also have healthy lifestyle like avoid fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and 5 days a week. Eat lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. Hope I have answered your query. Let me know if I can assist you further.  </s>