Resistant hypertension in young adults is increasingly encountered in urban clinical practice and warrants careful evaluation beyond routine pharmacologic escalation. Defined as blood pressure remaining above target despite adherence to ≥3 antihypertensive agents (including a diuretic) at optimal doses, it raises strong suspicion for secondary etiologies in this age group. In urban India, changing lifestyles, rising obesity, high dietary sodium intake, stress, and increasing metabolic syndrome prevalence are intersecting with traditionally underdiagnosed secondary causes.
Notably, secondary hypertension appears to be rising among younger urban populations. Primary aldosteronism, renovascular hypertension, chronic kidney disease, thyroid dysfunction, and substance-related causes (including sympathomimetics and recreational drugs) must be systematically excluded. Early identification is…
