Orthostatic hypertension can be related to over medication. You think it preferable to have an autoimmune autonomic complication? That's odd. Your medication can be reduced and the orthostatic hypertension will go away. Falling and stroke are vascular risks? Falling is due to lots of things including over medication, spine related disc issues that weaken muscles, BRAIN TUMOR, and many people go straight into their 90s without vascular issues. Home BP monitoring is not "essential" unless the cardiologist advises it. It is often contraindicated because of the anxiety around taking it. If a person who has "white coat syndrome" takes their own blood pressure, they need to take it at least three times in a row with small breaks in between and then average the number. Anxiety can raise blood pressure to enormous numbers. The only reason these numbers pose a real issue is if they are constant. Otherwise, it's wise to reduce overall anxiety and for some people that's just impossible. A "good rapport with a caring physician" is as common as winning the state lottery. Most doctors give each patient 15 minutes and barely remember their name, that's why they stare at the computer screen for hints regarding what's going on with this particular patient. Then there are doctors who have a very good "bedside manner" but that doesn't mean they're good doctors. None of this has anything to do with the poster's question.