Periodontitis Tied to Higher Blood Pressure in Otherwise Healthy Individuals

By Lisa Rapaport

April 02, 2021

(Reuters Health) - Periodontitis is associated with significantly higher blood pressure in otherwise healthy individuals, a new study suggests.

Researchers examined data on 250 adults with periodontitis and 250 adults without gum disease who were matched by age, sex, and body mass index (BMI). Overall, individuals with periodontitis had 3.36 mmHg higher mean systolic blood pressure and 2.16 mmHg higher mean diastolic blood pressure than controls without periodontitis.

In addition, people with periodontitis were significantly more likely to have systolic blood pressure of 140 mmHg or more (odds ratio 2.3), the study team reports in Hypertension.

"Oral diseases are often overlooked and only when acute problems arise do they trigger a visit to the dentist," said senior study author Francesco D'Aiuto, head of the Periodontology Unit at the University College London Eastman Dental Institute, in the UK.

"It might well be that both gum disease and hypertension are interconnected diseases and managing one would improve the other," D'Aiuto said by email.

For the analysis, researchers also measured markers of systemic inflammation including high-sensitivity C-reactive protein (CRP) and white cell counts. While both were higher in people with periodontitis, the levels of these markers of systemic inflammation did not appear to mediate the association between periodontitis and arterial blood pressure.

"This was an intriguing finding as most of the current evidence strongly suggests that periodontitis causes systemic inflammation and the treatment of periodontitis resolves the host response," D'Aiuto said. "It is possible that the impact of systemic inflammation on the development of hypertension is not as strong as previously thought."

Participants' mean age was 35 years, they were typically a healthy weight, and very few had comorbidities.

To assess gum health, participants underwent periodontal exams including detailed measures of gum disease severity, such as full-mouth dental plaque, bleeding of the gums, and depth of the infected gum pockets. Blood pressure assessments were measured three times for each participant to ensure accuracy, and researchers also collected fasting blood samples to test levels of white blood cells and high-sensitivity CRP.

Active gum inflammation identified by bleeding gums was associated with higher systolic blood pressure, the study found. In addition, periodontitis was associated with higher glucose and LDL cholesterol, as well as lower HDL cholesterol.

One limitation of the study is that it didn't account for several factors that can independently influence blood pressure, including abdominal obesity, salt intake, use of anti-inflammatory medications, use of hormone treatments, or other oral health conditions.

Even so, the results underscore that blood pressure screening should become a routine part of healthcare in young people with periodontitis, said Dr. Tom Guzik, chair of physiology and cardiovascular medicine at the University of Glasgow in the UK, and a professor of medicine at Jagiellonian University in Krakow, Poland.

"The current study not only confirms an association between gum disease and blood pressure but expands this knowledge to young subjects," Dr. Guzik, who wasn't involved in the study, said by email. "This is important, considering the high prevalence of gum disease."

SOURCE: https://bit.ly/3fAFcO2 Hypertension, online March 29, 2021.

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