Review shows link between gum disease and hypertension

2016 08 29 15 19 24 260 Heart Health Stethoscope 400

Having gum disease puts people at greater risk of developing high blood pressure, according to a review published September 24 in the European Society of Cardiology's journal, Cardiovascular Research.

Moderate-to-severe periodontitis was associated with a 22% increase in the risk for hypertension, while severe periodontitis was linked with 49% higher odds of hypertension, the authors found.

"These results suggest that oral health assessment and management of [periodontitis] could not only improve oral/overall health and quality of life but also be of relevance in the management of patients with hypertension," wrote the group, led by Eva Muñoz Aguilera, BDS, of the University College London Eastman Dental Institute Periodontology Unit.

Hypertension is the main preventable cause of cardiovascular disease, and periodontitis has been linked with an increased risk of heart attack and stroke. To examine the odds of high blood pressure in patients with moderate and severe gum disease, the researchers conducted a meta-analysis of 81 studies from 26 countries.

The average arterial blood pressure was higher in patients with gum disease, the results showed. The systolic blood pressure was 4.5 mmHg higher, and the diastolic blood pressure was 2 mmHg higher.

This is important because an average 5 mmHg blood pressure increase would be linked to a 25% higher risk of death due to ischemic heart disease and stroke, the authors noted.

Periodontitis may be connected to other systemic conditions, including diabetes, cardiovascular diseases, and neurological diseases, such as Alzheimer's, due to the way oral bacteria burden the body. The bacteria cause inflammation throughout the body, which affects the way blood vessels function. Genetics and other lifestyle habits, such as smoking and obesity, also may play a role in their connections.

After reviewing the studies, authors could not conclude whether treating periodontitis had a positive effect on blood pressure.

Despite the promising findings, they recognized several limitations, including the limited value of systematic reviews of observational studies for ascertaining causality. Also, observational studies have intrinsic biases, such as selection and information bias; therefore, the results should be interpreted within the context of the methodology used, they noted.

The review findings show the management of periodontitis could affect the management of high blood pressure, but longer and larger studies should be conducted to determine whether gum disease treatment benefits patients' cardiovascular health, according to the authors.

Also, they noted that patients with gum disease should be informed of their risks of high blood pressure and given guidance on lifestyle changes, such as maintaining a healthy diet.

"Our findings highlight the potential to improve cardiovascular outcomes by addressing poor oral health in the general population," the authors wrote.

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