People with periodontitis face increased risk of developing hypertension, a new UK study has claimed.
Meta-analysis carried out by UCL Eastman Dental Institute, London, UK, has found that moderate-to-severe periodontitis was associated with a 22% raised risk for hypertension, while severe periodontitis was linked with 49% higher odds of hypertension.
Senior author Professor Francesco D’Aiuto and his team compiled the best available evidence to examine the odds of high blood pressure in patients with moderate and severe gum disease, examining 81 studies from 26 countries.
“We observed a linear association: the more severe periodontitis is, the higher the probability of hypertension,” said Prof D’Aiuto, whose findings are published in the latest edition of Cardiovascular Research.
“The findings suggest that patients with gum disease should be informed of their risk and given advice on lifestyle changes to prevent high blood pressure such as exercise and a healthy diet.”
He said that hypertension could be the driver of heart attack and stroke in patients with periodontitis. Although previous research has suggested a connection between periodontitis and hypertension and that dental treatment might improve blood pressure, findings are inconclusive.
Lead author Dr Eva Munoz Aguilera said average arterial blood pressure was higher in patients with periodontitis – 4.5 mmHg higher systolic and 2 mmHg higher diastolic blood pressures – compared to those without.
“The differences are not negligible,” she said. “An average 5 mmHg blood pressure rise would be linked to a 25% increased risk of death from heart attack or stroke.”
Out of two interventional studies in the review, five showed a reduction in blood pressure following gum treatment and these changes also occurred in people with healthy blood pressure levels.
Professor D’Aiuto added: “There seems to be a continuum between oral health and blood pressure which exists in healthy and diseased states. The evidence suggesting periodontal therapy could reduce blood pressure remains inconclusive. In nearly all intervention studies, blood pressure was not the primary outcome. Randomised trials are needed to determine the impact of periodontal therapy on blood pressure.”
He said further research is needed to examine whether or not patients with high blood pressure have a raised likelihood of gum disease.
Aguilera EM, Suvan J, Buti J, et al. Periodontitis is associated with hypertension. A systematic review and meta-analysis. Cardiovasc Res 24 September 2019.
https://academic.oup.com/cardiovascres/article-lookup/doi/10.1093/cvr/cvz201
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