Hi, @gcranor. I'm a decades long hypertensive individual, age 86 now, and I have had a lot of experience with medical care for the condition over the years -- mostly with medications (a dozen or more different ones). Here are some things I learned (I'll tell you more if you are interested):

First, my cardiologists treated me with the usual medications -- diuretics and calcium channel blockers. Neither of the medicines or the medical specialty of cardiology solved my problem. My HMO urged me to get diagnosis from a nephrologist, a kidney doctor, on the basis of the fact that kidneys and their jockeys, the adrenal glands, are more responsible for hypertension. My switch occurred after we (my medical team and I) tried a half-dozen different medications to little avail. After 10 years with a nephrologist heading my medical team, I'm still here, under different medication, and with diet and behavioral instructions that keep me focused and healthy. And my nephrologist deserves all the credit for relentlessly studying me until she found an inherited kidney problem that contributed to the other symptoms. She partnered with an endocrinologist to conduct the extensive research that tracked down the causes and the treatments for my disease.

Second, I could not have survived without my medical team. It was crucial for us to scope out the foundation for my problem, because treating it depends on concrete and comprehensive understanding of what's wrong with me. As medical tests provide more information over time, it's vital to know where I came from, what changed, and what caused the changes. That led to totally logical therapies, some of which worked better than others.

Third, after 30 years of therapy, cardiologists were added back into my medical team, because I developed Atrial Fibrillation, a heart rhythm problem that sometimes allows blood to hang around in an upper chamber of the heart -- long enough to turn out small clots. One of those clots traveled to my brain and blocked a small area, causing a small stroke, the impact of which is still with me but not with extensive problems. Given the brain involvement, though, a neurologist is also a member of my team now, and that has helped me deal with relatively minor nerve problems elsewhere in my body.

I hope you can see some indications in my experiences of what might be helpful to you. I'll be pleased to communicate further with you if you have any questions and think I could help. Martin