43 year old male. hbp. feeling lightheaded and extreme fatigue for 2 years. slight chest pain started recently. what could be the issue?

See your doctor.: This could be nothing other than deconditioning and fatigue, but given your history of hypertension one must consider the possibility that this is an indication of coronary artery disease. I would urge you to see your physician promptly and to consider testing for heart disease; this might include a physical exam, ekg, blood tests and\or a stress test.