High blood pressure, or periodontitis to blame!? European study

Recently, a study published in Hypertension found that compared with people without periodontitis, people with periodontitis had an average systolic blood pressure that was 3.36 mmHg higher and an average diastolic blood pressure that was 2.16 mmHg higher.

Furthermore, the diagnosis of periodontitis was more likely to be associated with mean systolic blood pressure and systolic blood pressure ≥140 mmHg, independent of common cardiovascular risk factors. When modeling systolic blood pressure and incorporating serial periodontal status, the results were similar.

Additionally, active gingival inflammation (determined by gingival bleeding) was associated with higher systolic blood pressure.

With a threshold of ≥130/80 mmHg, 50% of patients with periodontal disease could be diagnosed with hypertension, compared with 42% of those without periodontitis.

Compared with the control group, patients with periodontitis had higher blood sugar, low-density lipoprotein cholesterol levels, high-sensitivity C-reactive protein, and white blood cell levels, and lower levels of good cholesterol, high-density lipoprotein cholesterol.

The study included 250 patients with periodontitis and 250 people without periodontitis. These participants had no other chronic diseases, with a median age of 35 years and 52.6% were women.

Regarding periodontal disease and cardiovascular disease, in 2020, the consensus jointly released by the European Federation of Periodontology (EFP) and the World Heart Federation (WHF) pointed out:

Patients with cardiovascular disease should be informed of the harm of periodontitis to heart health; they should be asked whether they have any signs or symptoms of periodontitis, such as bleeding gums when brushing or eating, loose teeth, gum abscesses, and bad breath.

For cardiovascular patients with periodontitis, further periodontal evaluation and regular periodontal examinations and treatments are recommended; for those without periodontitis, regular preventive periodontal monitoring is recommended.

All patients with newly diagnosed cardiovascular disease should be referred for periodontal examination as part of cardiovascular disease management.

A collaborative disciplinary relationship should be established with the dentist to avoid bleeding or ischemic events, especially in patients on anticoagulant or antiplatelet therapy.

The consensus emphasizes that periodontitis is not only a disease of the oral cavity, but is also independently associated with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and chronic kidney disease. Cardiovascular disease patients and high-risk patients should pay attention to keeping their teeth and gums clean, such as brushing their teeth twice a day, paying attention to cleaning between teeth, and using anti-plaque mouthwash or specific dentifrice according to doctor's advice.

source:

[1]Muñoz Aguilera E, Suvan J, Orlandi M, et al. Association Between Periodontitis and Blood Pressure Highlighted in Systemically Healthy Individuals: Results From a Nested Case-Control Study. Hypertension. 2021 Mar 29.

[2]Sanz M, Del Castillo AM, Jepsen S, et al. Periodontitis and Cardiovascular Diseases. Consensus Report. Glob Heart, 2020, 15(1): 1.

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