You don't mention your age and it is relevant in terms of your risk for having an untoward event - like a stroke
Regardless, 180/100 is at a level that should be addressed...stroke level? probably not, but long term damage to the heart, kidney, penis, and eyes are of your concern. Additionally you have at least two major risk factors for coronary disease (smoking
history - [congrats on quitting] and hypertension
). So loweing your systolic pressure to between 120 and 130 will further reduce your risk for having heart disease
I think primary doctors get overwhelmed by the number of health issues that they need to address every day with every patient. Working in a specialty clinic, I see the results of poorly controlled blood pressure every day. It can be as big a deal as having a heart attack
in terms of reducing heart function over time. People always seem so surprised to find that this blood pressure that they have been ignoring for decades destroyed their heart function and now they have congestive failure.
It is time to start a medication. Typical starting agents would include ACE inhibitors, diuretics, and calcium channel blockers with Beta blockers next on the list. It is not uncommon that more than a single agent is necessary to achieve goal.
Lastly, you may also want to be evaluated for secondary reasons for hypertension such as renal artery stenosis
and sleep apnea
, which both can dramatically raise blood pressure.
I hope this helps. Good luck.