One of your points after another are familiar to me for similar reasons, teatime. My BP also has gone up in the last couple of years, after 25 years of treatment with a diverse arsenal of medications, among them a group of calcium channel blockers that eventually swelled my ankles and feet -- not painfully, but threatening in other ways. My issue IS heredity; I inherited a syndrome under which my kidneys fail to reclaim potassium, and hypokalemia was the crux of my problems for a couple of decades. Fortunately, my HMO bypasses cardiologists and sends hypertensive patients to its nephrologists. I was treated by a brilliant kidney doctor three years ago; she diagnosed my syndrome and prescribed a potassium-sparing diuretic, supported by Lisinopril, and that stabilized my BP -- until last year, when my Internist discovered that I have a-fib and referred me to a cardiologist who put me on Coumadin therapy to avoid clotting around my heart valves. Since then, diet and exercise regimens have not stopped my rising BP, and even though I'm on maximum doses of my two main medications, my common daily BP averages around 150/90. Next week, I have an appointment to renew relations with my nephrologist, hoping she can repeat the effective treatment of three years ago. My bet is that she will tell me to double my physical exercise -- and keep an eye on my potassium level and my heart rate.