Is Blood Pressure Of 150/130 A Cause For Concern?
Needs to change the medicine.
First thing, you mentioned about congestive heart failure, have you got your echo done, and try to find out the cause, if not you should. If heart function is low then may need further investigation. I guess you don't have any chest pain or heaviness especially on exertion.
Secondly, about your bp, it's a age related change occurs due to hardening of vessel, but this needs to be controlled. Atenolol is not strong antihypertensive medicine and also not very effective for lower bp.
First you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have LOW salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week and most of the readings should be less than 140/90 mmhg. Also have fluids including water tea milk coffee etc restriction due to congestive heart failure. Regular exercises like brisk walking, walking according your capacity atleast 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once..
You should get medicine like telmisartan and hydrochlorothiazide(40/12.5) combination prescribed for bp, which is effective medicine.
What would cause my reading to be so high?
Multiple factors coming together
Firstly, at baseline line you are a hypertensive patient that probably lead to your enlarged heart. So make sure your bp is under control for the treatment of same with or without medicine.
Secondly, high bp occurs due to hardening of blood vessels as age progresses and on the top of it, blood pressure being a very dynamic parameter, it can increase with activities, stress, anxiety, change in diet like increased salt intake, cold exposure, smoking or drugs if any. There are multiple causes. Importantly single reading is not that important, we have to look at a average readings. so keep monitoring it and most of readings, may not all be all should be 140/90.