Hi, I understand your concern and I ll try to help you. Hypertension is a very common disease and is related to genetic factors and lifestyle that people have. Hypertension has no cure and patients need to change the lifestyle and often using medications to lower blood pressure throughout life. Your question is a bit confusing and I understand that you have hypertension for at least two decades, is a loss of blood in the urine (hematuria), flank pain, and ringing in the ears and is systolic pressure and very close diastolic. I will address each of these problems. The loss of blood in the urine and flank pain may be related to a disease that leads to the formation of stones in the urinary tract, known as nephrolithiasis. This disease is one of the most common cause of blood in the urine, as well as urinary infections. There are diseases that can cause increased blood pressure and hematuria secondary to kidney inflammation known as nephritis. To identify the cause of the loss of blood in the urine, it is important that your doctor search for the presence of these stones with tomography urinary tract and a cystoscopy, and seek signs of inflammation in the kidneys with specific blood tests. The ringing in the ears is usually related to poorly controlled hypertension or the vestibular system of the inner ear diseases. The vestibular system is one of the responsible for the body balance and when it is compromised can cause dizziness, feeling stuffy ear and tinnitus, being known as Meniere disease. Finally, when the systolic and diastolic are very close, the first thing to do is check if the devices and pressure measurement technique are correct. If these pressures are even close, it is important to search for signs of heart failure with loss of contractility of the heart muscle. This research can be done initially with an echocardiogram. It is important to look for a strict control of blood pressure levels to reduce the risk of complications secondary to poorly controlled hypertension as cerebral infarction, myocardial infarction, heart failure, kidney failure and blindness. To achieve this control is necessary to seek healthy lifestyle with proper nutrition, regular exercise, weight loss, sleep apnea control, in addition to the rigorous use of antihypertensive medications. Hope I have answered your question. If you have any further questions I will be happy to help you. Wish you good health.