Brief Answer: Additional causes, as given below, need evaluation Detailed Answer: Hi young lady, Thanks for your query. * Firstly, hypertension in young age, most commonly occurs as a result of unhealthy lifestyle (overweight, lack of exercise, sedentary habits, excessive consumption of junk/fast food, aerated drinks; smoking and excess alcohol intake etc..). * However, in your case, presence of refractory hypertension (your BP still uncontrolled despite being on so many potent anti-hypertensive drugs), presence of inexplicable tachycardia and GERD (which could actually be irritable bowels) : the symptoms point towards TWO conditions :- - Pheochromocytoma :- a tumor of adrenal glands (located on the upper end of each kidney) which produces excessive amount of adrenaline and related hormones. Adrenaline significantly raises the BP, and also cause unexplained tachycardia. Besides, there are occasional tremors, persistent anxiety, occasional excessive sweating, pounding heart etc... A CT/MRI Scan of the adrenal glands will reveal a tumor in this case. It can also be diagnosed by measuring cortisol levels. - Coarctation of Aorta :- that is, a congenital stricture of the main blood vessel (called Aorta) which arises from the heart and supplies blood to the entire body. The stricture is present in the initial portion of Aorta. This condition is best diagnosed by angiography. During your next visit to the doctor, ask him to measure your BP in BOTH ARMS. The diagnosis will be confirmed, if there is a wide variation in BP readings of both arms. It may be noted that hypertension in BOTH conditions is very difficult to control. - Polycystic Ovarian Syndrome :- which is characterized by gain in weight during teens or early adulthood, irregular menstruation, hypertension, diabetes, mood swings, hair-loss with male-type hair growth, and presence of ovarian cysts. This is due to excessive male hormones in the blood. Hence, Diabetes needs to be ruled out. - Rarely, there may be a tumor in the pituitary gland located in the brain. This tumor produces in excess quantities of hormones including the one which stimulates adrenal glands to over-produce excess adrenalin and related hormones. I therefore strongly recommend that you discuss my opinion /views / recommendations with your treating doctor during your next appointment. I am sure he will agree with my opinion and will order relevant tests to rule-out/confirm the above-mentioned conditions. Hope you find my response as helpful and informative. Do revert back to me if you have further queries : I will be happy to help you. Dr. Rakesh Karanwal

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