** 1. Pathophysiology of Hypertension can be understood on the basis of Blood pressure i.e. cardiac output (systolic) and peripheral resistance (diastolic), where the typical haemodynamic finding in established hypertension is an elevated peripheral resistance and normal cardiac output. [as you have not mentioned the blood pressure values,so cannot comment on the subject] 2. There are certain modifiable factors in your history which can contribute to hypertension: i. Obesity: (weight gain): is a major but controllable risk factor for hypertension, with 2lb weight gain there is rise of systolic blood pressure by 1 mm Hg. ii. Diabetes: because there is insulin resistance and hyperinsulinemia: both these factors causes increased sympathetic activity,increased sodium retention and enhanced vascular hypertrophy. 3. St/T changes in lateral leads mean changes occurring in the Left side of the heart, and need evaluation by a Cardiologist to rule out any changes in the Left ventricle with further investigations . 4. calcium deposits in the aortic arch means that it can cause stiffening of the aortic valve, which can narrow the aortic valve,causing reduced blood flow through the heart. [If untreated, this condition can lead to chest pain, arrhythmia, heart failure or cardiac arrest 5. The first sign of aortic calcification is often a heart murmur [probable s4 sound]. Aortic calcification can be the first sign of heart disease, so it is important for this condition to be monitored regularly. PS: Additional investigations which may be required are: Lipid Profile, Chest X-ray, Echocardiogram.