Mother In Law Age 86 Has Been Taking Blood Pressure

Mother in law age 86 has been taking Blood Pressure Meds for years. Recently she has experienced night time spikes in BP reaching 200+/100+. She has been to Emergency Room 2 times, once hospitalized. Had a stress test, MRI of kidneys, all normal. EKGs show some abnormalities. Metopralol, Amlodipine, Losartan, Hydrochlorithizide . Since the episodes she has added some Hydralazine 25 every 8 hrs. Again , the spikes occur more into the evening and night time hours.