In Hypertension, Could Gum Disease Affect Treatment Outcomes?

Patients with hypertension with good periodontal health are more likely to have better treatment outcomes and lower risk of treatment failure, according to a new study.¹

“Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control,” said lead study author Davide Pietropaoli, DDS, PhD, of the University of L’Aquila in Italy, in a press release.²

Dr Pietropaoli and colleagues arrived at their conclusion following a retrospective, cross-sectional analysis of 2009-2014 National Health and Nutrition Examination Survey data on adults aged 30 years or older with and without periodontitis.

The presence and absence of periodontitis and related clinical parameters were used to assess BP as both a continuous and categorical variable. Progressively adjusted models were used to determine systolic BP means and odds ratios for uncontrolled BP based on the presence and severity of periodontitis.

Results of the study revealed that adults with hypertension and periodontitis had a mean systolic BP that was about 2.3 mm Hg to 3 mm Hg higher compared with those without periodontitis. Following multiple adjustments, the presence of periodontitis was also tied to antihypertensive treatment failure. This risk increased with disease severity.

“A good periodontal health is associated with better systolic BP profile during antihypertensive therapy by about 2.3 to 3 mm Hg and with lower odds of antihypertensive treatment failure,” Dr Pietropaoli and colleagues wrote.

“Dedicated studies are needed to test the impact of periodontal therapy on BP and the long-term effects on cardiovascular outcomes of this complementary approach to systemic health,” they concluded.—Christina Vogt

References:

1. Pietropaoli D, Del Pinto R, Ferri C, et al. Poor oral health and blood pressure control among US hypertensive adults [Published online October 22, 2018]. Hypertension. doi:10.1161/HYPERTENSIONAHA.118.11528

2. Poor oral health linked to higher blood pressure, worse blood pressure control [press release]. Dallas, TX. American Heart Association/American Stroke Association. October 22, 2018. https://newsroom.heart.org/news/poor-oral-health-linked-to-higher-blood-pressure-worse-blood-pressure-control?preview=c84d Accessed on October 22, 2018.