<s>[INST] I am 56 and are on several blood pressure medication, I do not understand that when I do any type of exertion such as walking or anything my blood pressure goes up extremely high and my heart rate sky rockets. I am in cardiac rehab, but yesterday they wouldnt let me participate because of this problem. when I am at rest my bp medcine make me feel as if Im going to past out. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Elevated blood pressure on exertion is seen with early heart failure, coronary artery disease (CAD) and valvular heart disease. Since you are already having hypertension, possibility of heart failure and CAD is more. So better not to perform cardio rehab. First consult cardiologist and get done ECG, 2d echo, stress test (trade mill test) and coronary angiography to rule out heart diseases. If it is CAD then you will need angioplasty (stenting). You may need diuretics and other cardiac supportive Chat Doctor.  Don't worry, you will be alright with all these. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>