Um... Wow... Four comments:

a) Does she get "white coat syndrome"? Get really nervous while in the doctor's office or when getting her pressure checked? You might want to verify that result with a home reading or in a relaxed environment. Did the 24 hour pressure monitor show any changes over time?

b) Does her pressure go down over the weekend or when on vacation? This would be a sign that the job is a major factor in the pressure.

c) Does she have a family history of really high pressure?

d) I really think professional medication would be really a good idea at this point!!!