Have you checked with her endo regarding her levels, maybe another blood draw is necessary to check.  I would have thought that lowering her florinef rather than her cortef would result in lowering her blood pressure.  Has the endo tried doing this?  If the results of the blood draw show that her 17OHP and plasma renin levels are good, then maybe it will be necessary to treat the high blood pressure another way.  As far as the temper tantrums go, it is not uncommon for a lot of children (both CAH and nonCAH) to behave like this during this time of the day.  Our 7 year old CAH daughter has never had a temper tantrum or behaved in an aggressive manner, even when her levels have been out.   However, other parents on this board state that their children’s mood is affected by medication levels.  It really is a hard thing to determine whether or not some things to do with our CAH children are CAH-related or not.  This is one thing that I find hardest to deal with in regard to our CAH daughter.  Good luck