IIRC, elevated BP issuance has changed within the last 12 months. If you meet certain criteria, the AME can do a CACI issuance (but check with Bruce on this to be certain).
Elevated BP needs to be addressed. Bruce has chased us airmen around the hangar more than once on this topic, as have the cariac docs that post here. Untreated, hypertension is a time bomb that can go off at anytime and in the worst ways. Treated, even with meds, it's a simple thing and an easy adjustment to your lifestyle.
BP is such an up-and-down thing. Most of the time it's OK, but seems to spike when you don't want it to. My PCP finally relented and called it "benign hypertension", but she's not an AME.
But let's get real here: if I buy the farm while flying my killer airplane, I'll probably wipe out a half dozen pine trees. On the other hand, if you're driving a Ford Exterminator when the reaper calls, you could easily take out a carload of nuns. What's up with that?