BP of 160-190/110-135 at 33 years of age that has persisted for 5-6 years with normal cardiac, renal, and vascular workup is most likely Primary (Essential) Hypertension â which means high BP without a single identifiable cause, driven by a combination of genetics, lifestyle, stress, and hormonal factors. However, at this severity and age, a few conditions are still worth re-investigating: aldosteronism (adrenal hormone excess), pheochromocytoma (adrenal tumour), and sleep apnoea â as these can be missed in routine workups.
Next Steps
Please consult me directly on Practo for a detailed evaluation â I can review his full history and guide whether additional hormonal tests (serum aldosterone, 24-hour urine metanephrines) are warranted before committing to long-term medication management.