Not a pilot, not aircrew but my job requires me to pass a medical annually.
I was first diagnosed as hypertensive in 1974 and put on a diet to lose weight, having stopped smoking a year before and discovered the delights of eating.
The diet worked and my BP normalised until, in 1979 it was found to be raised again and I started on medication (beta blockers). Since then I've been through the different stages of medical thinking as described by Ginger, of one agent dosage increased until effective, and later a mixture of several agents at a lower dosage. I chose to follow the doc's instructions and I'm still working 30 years later.
It's ok to say "the tablets can wait till Monday" but sooner or later you have to decide to take them or not. Either you do take your medicine and continue a normal working life or find that at your next medical, or the one after, the choice may be taken out of your hands.
If you do start on the prescribed medication then of course your GP will need to see you after a couple of weeks to check what effect the treatment is having on your BP and if you are noticing any side effects. He/she may want to change the treatment to another agent or a higher dosage so a period of monitoring is essential.
What is absolutely certain is that you need to have your BP controlled and if it means a lifetime on medication, so be it. What is equally certain is that hypertension won't just go away.
s37