Hello. Thank you for your question and welcome to HCM. I understand your concern. High blood pressure (hypertension) is a condition that should be maintained under tight control, ı.e. under 140/90 mmHg, because there are a lot of studies that confirm that a long-standing, above these figures, blood pressure produces other organ damages, such as kidneys and eyes. Therefore, ıf the fıgures you provided are constant findings, this is a sign that an another blood pressure-controlling drug should be added to your therapy. I would recommend you a beta-blocker, which not only lower the blood pressure, but also reduce the heart rate, thus the cardiac workload is reduced. Combining your age and hypertension, you have at least two known risk factors for coronary artery disease. So, by the body of studies that exist, aspirin should be added to your therapy as a primary prevention (I assume by blood thinners you meant aspirin). The thing with the minimally leaking valve is not to worry about, at least at this moment. It may become an issue after several years, or never. I recommend you to discuss with your cardiologist the possibility of adding these two drugs to your regimen. And, last, I suggest you to run blood levels of total cholesterol, LDL and HDL fractions, and triglycerides. I hope I was helpful with my answer. Best regards. Dr. Meriton