What is the most likely reason, Joes BP elevation?

Myocardial Infarction
Joe Hutchington, 53 yr. old male. Presented to the Emergency Department with central crushing chest pain, pain score 8/10, pale and sweating. Joe has a history of osteoporosis and is also insulin dependent type 2 diabetic. He admits to being a pack a day smoker and drinks 3 red wine glasses a night to help him relax. He maintains 30 minute, exercise daily.
His vital signs on first presentation are:

Blood Pressure – 167/72
Respiratory Rate – 17
O2 – 97%
Heart Rate – 137 and arrhythmic
Blood Glucose Level – 6.2
Urine output – >30 ml PH
Capillary refill time – <2 seconds
Questions:

Symptoms

Q1) What is the most likely reason, Joes BP elevation?

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