High blood pressure can be due to genetic factors or due to some disease. To find whether you have blood pressure without a cause or essential hypertension you need to eliminate the various causes of hypertension. Recent head injury, hyperthyroidism, renal artery stenosis (by dopplar studies or MRI), abnormal kidney function (by kidney function tests), hyper function of adrenals, Cushing’s syndrome, abnormal liver function etc need to be ruled out. You should consult a cardiologist for high BP. To diagnose the cause tests like kidney function, liver function, lipid profile, thyroid, adrenal gland function, EKG, ECHO, tread mill etc are done. If no cause is found then what you have is essential hypertension. The doctor will need to adjust the type and dose of medication. This may need a few trials before a medication that suits you is adjusted at an optimal dose. Keep a morning evening record of your blood pressure for a few days. If your blood pressure remains high after medication, then there are two possibilities. Either the medication is not suiting you. OR there is some underlying cause which needs to be eliminated. Apart from medication you need to eat healthy, exercise regularly as advised by the cardiologist, reduce salt intake, take alcohol with caution or better avoid, quit smoking if you do and reduce total calorie intake in a day, maintain your weight, cholesterol and lipids under control. Take care!