People with severe gum disease may be twice as likely to have increased blood pressure

Research highlights:

  • Research shows that periodontitis, a severe form of gum disease, is associated with increased blood pressure in otherwise healthy individuals.
  • The study of 500 adults with and without gum disease found that about 50 percent may have undetected high blood pressure.
  • Promoting good oral health can help reduce the risk of gum disease as well as high blood pressure and its complications.

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DALLAS, March 29, 2021 – Adults with periodontitis, a severe gum infection, are less likely to have gum disease than those with healthy gums, according to a new study published today in the Journal of Periodontology. Than, the possibility of elevated blood pressure is significantly greater. hypertensionJournal of the American Heart Association.

Previous research has found an association between high blood pressure and periodontitis, however, studies confirming the details of this association are sparse. Periodontitis is an infection of the gum tissue that holds teeth in place, and can lead to progressive inflammation, bone or tooth loss. Prevention and treatment of periodontitis are cost-effective, reduce systemic markers of inflammation, and improve the function of the endothelium (the membrane lining the heart and blood vessels).

“Patients with gum disease often experience symptoms of increased blood pressure, especially when the gums are inflamed or the gums bleed,” said the study's lead author, D.D.S., MD, a senior fellow in dentistry at University College London Eastman Dental. Eva Muñoz Aguilera said the institute is located in London, England. “Elevated blood pressure is often asymptomatic, and many people may not be aware that they are at increased risk for cardiovascular complications. We aimed to investigate the relationship between severe periodontitis and hypertension in healthy adults with undiagnosed hypertension. .

The study included 250 adults with systemic severe periodontitis (≥50% of teeth had gum infection) and a control group of 250 otherwise healthy adults without severe gum disease. Other chronic health problems. The average age of participants was 35 years, and 52.6% were female. The study was conducted in collaboration with the Department of Dentistry at the International University of Catalonia in Barcelona, ​​Spain.

All participants underwent a comprehensive periodontal examination, which included detailed measurements of gum disease severity, such as plaque throughout the mouth, gum bleeding, and depth of infected gum pockets. Each participant's blood pressure assessment was measured three times to ensure accuracy. Fasting blood samples were also collected and analyzed for high levels of white blood cells and high-sensitivity C-reactive protein (hsCRP), as both are markers of increased inflammation in the body. Other information analyzed as confounders included family history of cardiovascular disease, age, body mass index, sex, race, smoking and physical activity level.

Researchers found that a diagnosis of gum disease was associated with higher rates of high blood pressure, independent of common cardiovascular risk factors. Compared with people with healthy gums, people with gum disease were twice as likely to have a systolic blood pressure ≥140 mm Hg (14% vs. 7%, respectively). Researchers also found:

  • The presence of active gingival inflammation (identified by bleeding gums) is associated with higher systolic blood pressure.
  • Compared with controls, participants with periodontitis had elevated levels of glucose, low-density lipoprotein (“bad” cholesterol), hsCRP and white blood cells, and lower levels of high-density lipoprotein (“good” cholesterol).
  • Nearly 50% of participants with gum disease and 42% of controls had blood pressure values ​​diagnosable as hypertension, defined as ≥130/80 mmHg.

“This evidence suggests that periodontal bacteria can cause damage to the gums and trigger an inflammatory response that affects the development of systemic diseases, including hypertension,” said corresponding author Dr. Francesco D'Aiuto. Professor of Periodontology and Head of the Department of Periodontology at the Mann Dental Institute. “This means that the link between gum disease and increased blood pressure exists long before patients develop high blood pressure. Our study also confirms that a worryingly large number of people are unaware that they may be diagnosed with high blood pressure.”

D'Aiuto added, “Combining high blood pressure screening by dental professionals with referral to primary care professionals and periodontal disease screening by medical professionals with referral to periodontists can improve both.” Detection and treatment of these diseases, thereby improving oral health and reducing the burden of high blood pressure and its diseases. Oral health strategies such as brushing twice a day are proven to be highly effective in managing and preventing the most common oral diseases, our findings show. They can also be a powerful and affordable tool to help prevent high blood pressure.

The study did not take into account other factors that may affect blood pressure, such as abdominal obesity, salt intake, use of anti-inflammatory medications, hormonal treatments or stress, or any other oral health conditions.

Co-authors are Jeanie Suvan, Dip.DH, MS, PhD; Marco Orlandi, DDS, PhD; Queralt Miró Catalina, BA, MS; Jose Nart, DDS, PhD

This research was funded by the UK Department of Health, UCL National Institute for Health Research Biomedical Research Center/UCL Hospitals. Orlandi holds NIHR clinical lecturer qualifications. D'Aiuto received a Clinical Senior Lecturer Award supported by the UK Clinical Research Partnership.

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