Benign Paroxysmal Positional Vertigo (BPPV): This condition is common in the elderly and can cause vertigo, which is often described as the room spinning. It is related to the movement of calcium particles in the inner ear and can be exacerbated by head movements.

Vestibular Migraine: Although more common in younger populations, vestibular migraines can occur in the elderly and cause vertigo without the typical headache associated with migraines.
Labyrinthitis: An inner ear infection that can cause vertigo, hearing loss, and tinnitus. The elderly are more susceptible due to decreased immune function.
Medication Side Effects: Various medications, including those for hypertension and diabetes, can cause dizziness or vertigo as a side effect.

Posterior Circulation Stroke: Although orthostatic vitals are negative, a stroke in the posterior circulation (including the vertebrobasilar system) can cause vertigo and is a medical emergency. The absence of orthostatic changes does not rule out this diagnosis.
Transient Ischemic Attack (TIA): Similar to a stroke, a TIA can cause vertigo and is a warning sign for a potential future stroke.
Cardiac Causes (e.g., Arrhythmias): Certain cardiac conditions can lead to reduced blood flow to the brain, causing vertigo. Given the patient's history of uncontrolled hypertension, cardiac causes should be considered.

Meniere's Disease: A disorder of the inner ear that causes episodes of vertigo, tinnitus, hearing loss, and ear fullness. It is less common than BPPV but should be considered if symptoms persist.
Acoustic Neuroma: A benign tumor on the nerve connecting the inner ear to the brain, which can cause vertigo, hearing loss, and tinnitus. It is rare but important to diagnose due to its potential impact on quality of life.
Multiple System Atrophy: A rare neurodegenerative disorder that can cause vertigo among other symptoms like parkinsonism and autonomic dysfunction.