Hello Dr Mazharhamdani
Welcome to HCM
You are hypertensive for last 5 years along with positive family history of IHD, Exertional pain we always suspect angina and as your CT angio is normal and negative TMT a significant epicardial coronary disease is ruled out.
Angina is clinical diagnosis so possibility of microvascular disease
and a coronary spasm
may be there.
Coronary angiography may not be required,but disscuss with your cardiologist about changing antihypertensive to beta blocker
or Calcium channel blockermay be used as it will take care of angina and blood pressure.
Other risk factors must be taken care like Lipid Profile
,Diabetes,Overweight and Smoking.
Any risk factor present must be taken care if present.
In consultation with Cardiologist preventive drugs like statin and aspirin may be used.
Other small risk factors Uric acid,Homocysteine
,level of CRP may be checked and treated if abnormal.
Best of luck