Why is it I have symptoms of high blood pressure but not high BP?

What’s happening is that these symptoms are not coming from high blood pressure. A reading around 116/83 is normal and hypertension causes damage only when blood pressure stays high over time WITHOUT treatment.
The chest pain you are describing fits anxiety, not heart disease or a blood pressure issue. Anxiety related chest pain is dull, tight, or aching, it can linger, it feels very real and frightening, and it does not line up with blood pressure readings.
The blind spot is also not a sign of blood pressure damage. Eye damage from hypertension happens with long term uncontrolled high blood pressure and causes persistent vision loss, not blind spots you only see sometimes. This sounds more like a visual aura, eye strain, or anxiety related visual processing changes.
Your blood pressure is controlled, your symptoms do not match hypertensive complications, and your emergency room evaluation ruled out heart related causes. Changing blood pressure medications would not help anxiety or migraine type symptoms, which is why you do not need an adjustment on your blood pressure medication when the numbers are already good.
Bottom line, you are not damaging your heart or organs. Your blood pressure is doing what it is supposed to do. The symptoms are real but they are not being caused by hypertension. Anxiety can convincingly mimic heart and vision symptoms.
Waiting for your doctor’s/NP's response is reasonable, but based on everything you have shared, there is no sign of missed hypertension danger. Continue taking amlodipine daily, use propranolol as needed, and focus on decompressing.

@ashlynnmae

Can I ask for more clarification on the vision disturbances that come with hypertension? It wouldn't just be a blind spot, right? Let alone one I don't always notice? Would it be more like losing my entire ability slowly over time with elevated readings? Would infrequent high readings contribute to this? Or only consistent ones?

@ehdog

Vision problems caused by hypertension are not subtle, not intermittent, and not limited to a small blind spot.
Hypertensive eye damage, called hypertensive retinopathy, only develops after long term, consistently uncontrolled blood pressure, typically over years. It results from ongoing damage to the small blood vessels in the retina. In real life, this causes persistent and worsening visual changes, not something you notice occasionally. People develop steadily worsening blurry vision, distortion, and/or larger areas of vision loss. It does not come and go, and it does not present as a small blind spot you sometimes notice and sometimes do not. You would clearly and repeatedly/always notice a problem.
This does not occur with normal or well controlled blood pressure. Infrequent spikes, anxiety related elevations, or isolated high readings do not cause this kind of damage. The risk exists only when blood pressure stays high most or all of the time.
With true hypertensive vision damage, doctors always see clear abnormalities on eye exam before patients notice it. By the time vision is affected, blood pressure has been uncontrolled for a long period and readings are significantly elevated.
So the answer is it would not be just a blind spot, especially not one you occasionally notice. It would be progressive, persistent, and obvious. Infrequent high readings do not cause this. Only consistently elevated, untreated blood pressure over time does.

@ashlynnmae

Hmm. Larger areas? What would that look like? Not that I probably have that. My readings seem okay on both cuffs consistently.

@ehdog

When hypertension affects vision, the loss is not tiny or subtle. “Larger areas” refers to whole sections of vision that are missing or severely blurred. This can look like a dark or gray area covering part or all of your visual field, difficulty seeing out of one side, or vision that appears washed out or distorted across a noticeable region. It interferes with life. You would notice it immediately, without needing to search for it.
This type of vision loss does not fluctuate. If someone has hypertensive eye damage, the problem is present every time they open their eyes. It does not appear and disappear, and it does not depend on focus or attention.
Hypertensive vision damage ONLY occurs with clearly uncontrolled blood pressure, much higher than yours, and over a long period of time.
A small, occasional blind spot that comes and goes is not how hypertensive eye disease presents. That pattern is consistent with migraine aura, visual strain, or anxiety related visual processing changes, especially in someone whose blood pressure is consistently normal on medication.
Since your readings are steady and normal on both cuffs, there is NO mechanism for hypertension to be causing vision problems. Nothing you’ve described matches hypertensive eye damage.

@ashlynnmae

Does it matter that my blind spot or the "crescent" spot in my vision is always there? I just can't always notice it. Only really on plain white surfaces, it is grey/black though and seems to be across a good portion of my vision.

@ehdog

If the spot is always physically present but you only notice it sometimes, such as on plain white surfaces, it is likely related to a migraine aura, visual processing quirk, or eye strain. The important points that show it is not caused by hypertension are:
Hypertensive vision problems do not appear only on certain backgrounds, they are persistent and clearly noticeable across all visual situations. They do not come and go in awareness, the loss is there every time you look, even if your brain partially filters it out. They occur in the context of long term, poorly controlled high blood pressure, which you do not have.
Because your blood pressure is well controlled and your readings are consistently normal, this spot is not caused by hypertension.

@ashlynnmae

I'm just anxious it sounds like it COULD be my BP and I was told everyone has a blindspot

@ehdog

Yes, everyone has a natural blind spot, and your brain usually fills it in. What you’re describing matches this normal blind spot, I never said otherwise, I have one too.
Hypertensive vision damage does not present like this. It is persistent, obvious across all visual environments, and only occurs after long term, uncontrolled high blood pressure, over MANY DECADES. Occasional or well controlled readings cannot cause it.
You notice it on certain high-m contrast surfaces because your brain highlights it in those situations, but it is not dangerous and is not related to hypertension.
I don’t understand how you interpreted this as possibly being caused by your blood pressure when I’ve explained in detail why it cannot be.

@ehdog I'm not sure what you mean by "symptoms of high blood pressure" because there are SELDOM true symptoms of elevated blood pressure. Undiagnosed or untreated high blood pressure has long been known as "the silent killer" because there are no symptoms until it has been excessively high for years, which causes damage to your heart and blood vessels. You are conscious of your slightly elevated BP, and are treating it - your readings are in the normal range, so you can breathe a sigh of relief.

So, the first time you had that "slightly dull chest pain" you were right to have it checked out. Now that you know anxiety is causing it, let's consider the issue of headaches.
Headaches can have MANY causes:
- dehydration is a big one - are you sure you are drinking enough water?
- excessive caffeine - coffee, energy drinks, sodas
- an irregular eating schedule, causing your blood sugar to rise and fall (this is NOT diabetes)
- poor diet resulting in eating too much sodium or sugar, not enough nutrients
- smoking or vaping
- too much screen time
- not enough exercise
- stress
- poor sleep or sleep habits

These are all things you can correct.

Oranges gave you some good information about your vision issues. If you are still concerned, maybe you can schedule an eye exam. Even if you don't already wear glasses, you should have your vision checked about every 5 years.

Please read this Mayo explanation about normal and elevated blood pressure and true hypertension:
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410