Thanks for all the responses. Maybe I should rephrase my question a bit:
Why do similar ICE cars not recommend 45 psi? I have not seen any sedan ICE cars recommending anything above 36 psi.
The Audi A7 is very similar to the Model S in terms of acceleration, body design, suspension, and tire size. The recommended pressure is 34 lbs (average). The car weights 350 lbs less than the MS, which accounts for a 2 or 3 lbs of pressure difference.
I realize that all cars handle a little differently, have different weight distributions, differently braking properties, etc. However, I doubt these two cars have major differences in these respects.
Just to give you an idea of where I'm coming from with these questions:
At higher PSI, you may get a nice sporty feel on roads in California and Florida. In Colorado and the Midwest, the ride changes from "Sporty" to "Red Wagon". I have a dormant bulging disc in my neck. It only flares up when I jog too much or ski bumps. However, the MS seems to be triggering inflammation when I drive more than 10 miles or so on the highway. I need to find a solution to soften the ride, or have the disc replaced, or sell the car. I'd like to avoid the latter two options.
But again, I don't want to make a change without be fairly certain that I'm not sacrificing safety for comfort.