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  Pat,   Thanks for your question.  Sorry to hear you are having problems.  I really cannot blame the difference from 2 x 160 mg to 1 x 320, which is equivalent.  It can take a week or two to see the full effect of a change in dosage.  I'm wondering if your pressure didn't drop too low resulting in your symptom.  I know that you recorded a high (168/110) during the attack, but could this have been a rebound response to the pressure bottoming out?  Your pressure readings otherwise are acceptable.   You need to contact your physician about this episode.  Because your pressure goes up and down (you said your prior readings ranged from 130/75 - 200/130), it might be time to look for possible causes of your high blood pressure, such as a kidney problem, vascular abnormality, or problem with an adrenal gland, as well as other possibilities.  Your doctor will know what to do.   The bottom line here, you have to find the cause, if any.  If there is no cause, then you have essential hypertension, and you need to get control before there is any end-organ damage.   Feel better.   Martin Cane, M.D.