How to create a presentation on secondary hypertension?

Creating a PowerPoint Presentation on Secondary Hypertension

A comprehensive PowerPoint presentation on secondary hypertension should focus on causes, diagnostic approaches, and management strategies, with emphasis on identifying potentially reversible conditions.

Slide Structure and Content Organization

Introduction Slides

• Define secondary hypertension (5-10% of hypertension cases with identifiable causes) 1
• Contrast with primary/essential hypertension
• Emphasize importance of identification (potentially curable/treatable)
• Include epidemiology data (prevalence varies by age group)

Clinical Presentation Slides

• Key features suggesting secondary hypertension:
  • Onset before age 30 or after age 50 1
  • Severe or resistant hypertension (requiring >3 medications) 2
  • Sudden worsening of previously controlled hypertension
  • Malignant hypertension with end-organ damage 3

Common Causes - Dedicate separate slides for each:

Renal Causes

• Renal parenchymal disease
  • Clinical features and diagnostic tests (eGFR, urinalysis, renal ultrasound) 4
• Renovascular hypertension
  • Features: abdominal bruits, sudden rise in creatinine with ACE inhibitors
  • Diagnostic approach: renal Doppler ultrasound, CT/MR angiography 4

Endocrine Causes

• Primary Aldosteronism
  • Present in ~20% of resistant hypertension cases 4
  • Often without hypokalemia in early stages
  • Screening: aldosterone-to-renin ratio 4
• Pheochromocytoma
  • Classic triad: episodic hypertension, headaches, sweating
  • Diagnostic tests: 24-hour urinary or plasma metanephrines 4
• Cushing's Syndrome
  • Physical features: central obesity, facial rounding, easy bruising
  • Testing: 24-hour urinary free cortisol, dexamethasone suppression 4
• Thyroid disorders and Hyperparathyroidism
  • Clinical features and screening tests 4

Other Important Causes

• Obstructive Sleep Apnea
  • Most prevalent secondary cause (up to 83% in resistant hypertension) 4
  • Risk factors: obesity, increased neck circumference (>40cm)
  • Diagnostic approach: polysomnography 4
• Coarctation of the Aorta
  • Physical findings: BP differences between arms or between arms and legs
  • Diagnostic imaging: echocardiogram, CT angiogram 4
• Drug-induced Hypertension
  • Include table of medications and substances:
    • NSAIDs, oral contraceptives, corticosteroids
    • Decongestants, anticancer drugs
    • Recreational drugs (cocaine, amphetamines)
    • Liquorice 3

Diagnostic Approach Slides

• Initial evaluation algorithm:
  • Basic testing for all patients: CBC, electrolytes, creatinine, glucose, lipids, TSH, urinalysis, ECG 4
  • Physical examination findings suggestive of secondary causes 3
• Include this diagnostic table:

Suspected Cause	Recommended Screening Test
Primary aldosteronism	Aldosterone-to-renin ratio
Renovascular hypertension	Renal Doppler ultrasound, CT/MR angiography
Pheochromocytoma	24h urinary/plasma metanephrines
Obstructive sleep apnea	Overnight polysomnography
Renal parenchymal disease	Renal ultrasound, urinalysis, eGFR
Cushing's syndrome	24h urinary free cortisol, dexamethasone suppression
Thyroid disease	TSH
Hyperparathyroidism	PTH, calcium, phosphate
Coarctation of aorta	Echocardiogram, CT angiogram [4]

Management Slides

• Cause-specific treatment approaches:
  • Renal artery stenosis: angioplasty for fibromuscular dysplasia, medical management for atherosclerotic disease 4
  • Primary aldosteronism: unilateral adrenalectomy or mineralocorticoid receptor antagonists 4
  • Pheochromocytoma: surgical removal after adequate alpha-blockade 4
  • OSA: weight loss, CPAP therapy 4
  • Drug-induced: medication adjustment/discontinuation

Hypertensive Emergency Slide

• Definition: BP ≥180/110 mmHg with acute hypertension-mediated organ damage 3
• Clinical presentations and immediate management
• Importance of controlled BP reduction

Case Studies

• Include 2-3 illustrative cases with:
  • Clinical presentation
  • Diagnostic workup
  • Treatment approach
  • Outcome

Conclusion Slide

• Key take-home messages
• When to suspect secondary hypertension
• Importance of systematic evaluation

Presentation Design Tips

• Use clear, readable fonts
• Include relevant images:
  • Pathophysiology diagrams
  • Diagnostic algorithm flowcharts
  • Key radiological findings (renal artery stenosis, adrenal adenoma)
  • Clinical photographs (when appropriate)
• Maintain consistent color scheme
• Use bullet points rather than paragraphs
• Include references on each slide or in a final slide

Common Pitfalls to Highlight

• Delaying evaluation for secondary causes in resistant hypertension
• Failing to consider medication effects as potential causes
• Improper preparation for endocrine testing (interfering medications) 2
• Overlooking obstructive sleep apnea as a common contributor
• Inadequate follow-up after treatment of secondary cause

This structured approach will create an informative and clinically useful presentation on secondary hypertension that emphasizes identification of potentially reversible causes.