27yo female with high blood pressure. echo states t wave inversion in the septal leads, consider ischemia what does this mean and is it bad?

I think you meant EKG shows "T wave inversion in the septal leads" not Echo. We use the term Echo for Echocardiogram, i.e. ultrasound examination of the heart. We need more info to give you a correct answer but I doubt that change is due to coronary heart disease at your age. However, echocardiogram is indicated in your case if you have not had one done recently. Take care!