I’ve had very similar issues since being diagnosed at 47, including increased blood pressure in general with stimulant meds, especially on Concerta. I generally function better on a higher dose, but there’s a trade-off in the way the hypertension makes me feel that tends to void the overall benefit. My doctor suggested that I might consider partnering it with blood pressure medicine, but I’ve opted to lower my dose instead. When I get enough sleep, water, exercise, and protein, and manage stress, it definitely helps bridge the gap. I currently switch between Vyvanse 20 mg extended relief and 5mg of short-acting as needed.