I've been dealing with high blood pressure for the past couple of weeks, and I've been measuring it every day. It's around 190/110, even though I'm taking Telmisartan 40mg. My blood pressure hasn't really improved. I also had some tests done, and my creatinine level is 1.8, urine protein is 2484, albumin is 3.3, and my vitamin B12 level is 82. What could be causing these issues, and what should I do next?

Uncontrolled High Blood Pressure and Laboratory Results_Concerns and Recommendations_1. _Uncontrolled hypertension_: Despite taking Telmisartan 40mg, your blood pressure remains elevated (190/110). This requires immediate attention to prevent cardiovascular complications.2. _Kidney function_: Your creatinine level (1.8) is slightly elevated, indicating potential kidney impairment. The high potassium level in your urine and proteinuria (2484) also suggest kidney damage.3. _Albumin levels_: Your albumin level (3.3) is within the normal range, which is a positive sign.4. _Vitamin B12 deficiency_: Your vitamin B12 level (82) is below the normal range (200-900 pg/mL), which may contribute to fatigue, weakness, and neurological symptoms._Recommendations_1. _Consult a cardiologist or nephrologist_: Schedule an appointment with a specialist to reassess your hypertension management and kidney function.2. _Adjust medication regimen_: Your doctor may consider adding or adjusting medications to better control your blood pressure and protect your kidneys.3. _Lifestyle modifications_: Implement lifestyle changes, such as:- Reducing sodium intake- Increasing potassium-rich foods- Engaging in regular physical activity- Maintaining a healthy weight- Getting adequate sleep4. _Vitamin B12 supplementation_: Discuss vitamin B12 supplementation with your doctor to address the deficiency.