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Periodontitis linked to hypertension in otherwise healthy people

By Melanie Hinze
Further support of a link between periodontitis and hypertension in otherwise healthy people has been found in a recent study published in Hypertension.

The nested case-control study included 250 participants with generalised severe periodontitis, defined as having more than 50% of teeth with infection and more than 30% with marginal alveolar bone loss. These participants were compared with 250 control participants without periodontitis, matched for age, sex and body mass index. Participants were aged 18 years or older and were otherwise healthy with no other chronic health conditions. They were recruited from clinical trials conducted between 2001 and 2018, and the research was completed in collaboration with the Department of Dentistry at the Universitat Internacional de Catalunya in Barcelona, Spain.

When compared with the control group, participants with periodontitis had a 3.36 mmHg higher mean systolic blood pressure (BP) and a 2.16 mmHg higher mean diastolic BP. They were 2.3 times more likely to have a systolic BP of 140 mmHg or more, and they had an almost 50% increased risk of their diastolic BP being 80mmHg or more.

Additionally, irrespective of periodontal status, bleeding gums was associated with higher mean systolic BP. As bleeding gums were the earliest sign of periodontal diseases and could be easily detected, this could represent a valuable parameter in BP screening, the study authors noted.

Undetected hypertension was also a common finding among the study population.

The authors concluded that oral health professionals could play an important part in the detection and management of hypertension. They also suggested that periodontal treatments could be a well-tolerated novelty nonpharmacological intervention for the management of hypertension.

John Curtin Distinguished Professor, Christopher Reid, who is a Cardiovascular Epidemiologist and Clinical Trialist at the Curtin School of Public Health in Perth, said that associations with oral health and cardiovascular disease or hypertension had been previously reported, and although the differences were small in this current study, at a population level they were important.

He also noted that a lack of association of inflammatory markers was interesting, potentially indicating only low-grade, widespread inflammation.

‘While this research demonstrated associations between periodontitis and hypertension, it didn’t demonstrate causality,’ he said, but added that ‘It does identify further awareness and opportunity for hypertension treatment and management.’
Hypertension 2021; 77: 1765-1774; doi: 10.1161/HYPERTENSIONAHA.120.16790.