Interesting predicament.
Don't know the regulation, but have much experience of managing hypertension. In reality, getting your blood pressure under control may take 6-12 months of tinkering-this is par for the course.
Each titration of dosage could have potential adverse effects, although in my experience, these are few and far between.
Authorities tend to get a bit hooked up on guidelines, recommendations, policies etc. AME's tend to be good at managing risk.