So, I have the hereditary hypertension issue and it sounds like you do as well. (since you were diagnosed so young). Question, how is your weight? I'm on medication and it will keep me in the 130 (ish) range. BUT, if I lose weight and exercise regularly, it WILL go lower for the top number and the other isn't effected. Does weight change your readings at all or exercise? Have you ever tracked that? https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974 Even on medication, you can try some control methods in terms of lifestyle to see if it helps. In general, medication is going to lower both numbers.