High Blood Pressure

66 year old female, endocarditis and mitro valve repair 15 yrs. ago, Sick sinus syndrome, pacemaker, 1 TIa. On Losartan 50 mg. Metoprolol 50 mg. Hydrochlorothiazide 2.5 mg. Amlodipine 2.5. Xeralto 20 mg. I keep having spiking bp episodes that last several days causing headaches and general illness. Wondering if there’s something else wrong w/body. Walk every day, no alcohol, watch salt. Not overweight. Frustrating. Any one have successful remedies w/out increasing meds?