I have a sharp pain on the left side of my head (only when i cough ) and i have the worst case of hypertension?

Does not sound good: Chronic hypertension increases risks for heart attack and stroke via atherosclerosis which damages the vessel wall and possibily cause anerysm--see pic here. When we get sick--bad cold, sinus/ear infection can cause headaches, especially with coughing. But you mentioned nothing else and so I am a bit concerned. I would take some cough meds, consult doc for eval as soon as possible. Good luck.