Malignant hypertension, cold feet, high catecholamines?

Patient

Q: I am a 24 year old white male, not overweight, once weekly binge drinker, daily moderate smoker. I have malignant hypertension for several years and can not determine the cause. May you suggest a possibility with which I can discuss with my doctor? My symptoms include constant cold feet, hair loss on outside shins, head pressure worsening with bending over, severe anxiety, occasional chest and left arm ache. Testing I have had done so far and results...
Echocardiogram and EKG - normal
Full blood panel - thyroid normal, not diabetic, Vitamin D too low to detect, rest of results normal.
24 hr Urine - very high catecholamines.
Kidney/Adrenal CAT - Normal.
Arterial Dopplers in legs - Normal.
Thyroid Ultrasound - normal.

I did not respond to 5 or 10 mg Amlodipine.... Have started Azor 10/40 several days ago and I do not seem to be responding... The only difference is that under intense stress (panic disorder) my BP does not go as high as 190/115... but instead 170/90. Home readings in most possible relaxed state indicate stage 1 hypertension... approx. 158-90 to 135/70...
I am scheduled for Nephrology one month away as for now I am at a loss.
My current regimen is 10/40 Azor once daily. 20mg Prozac once daily. Hydroxyzine 25mg as needed for anxiety. 50,000 iu Vit. D once weekly.
Thank you very much for your input.

Symptoms:  Hypertension, chest pain, headache, anxiety, cold feet
Doctor

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