Association Between Periodontal Disease and Left Ventricle Mass in Essential Hypertension

Abstract

Abstract-Chronic periodontitis has been associated with an increased risk for cardiovascular disease. Left ventricular mass is an established independent predictor of cardiovascular disease. In the present cross-sectional study, we tested the association between periodontitis and left ventricular mass in subjects with essential hypertension. One hundred four untreated subjects with essential hypertension underwent clinical examinations, including echocardiographic study, laboratory tests, and assessment of periodontal status according to the community periodontal index of treatment needs (CPITN eriodontium is a complex and highly specialized pressure-sensing system consisting of 4 tissues (cementum, periodontal ligament, alveolar bone, and junctional and sulcular epithelia) supporting the teeth. Of these structures, periodontal ligament is a dynamic tissue with a high rate of remodeling and turnover, which connects the teeth to the alveolar bone. 1 Prevalence of periodontal disease approaches 14% over a wide age span, including younger and elderly people. 1 Periodontitis begins with a loss of alveolar bone and subsequent formation of a pocked around the tooth, the final stage being tooth mobility and loss. 2 Periodontal pocket can be detected with a periodontal probe and estimated through measurement of distance from gingival margin to the base of the periodontal pocket. 3 In a healthy periodontium, there is no loss of epithelial attachment or pocket formation, and the gingival crevice is Ͻ2 mm deep. 3 Established risk factors for periodontal disease are dental plaque, calculus, age, genetics, smoking, and diabetes. 4 At least 9 cohort studies 5-13 examined the association between periodontal disease and coronary heart disease (CHD), with conflicting results. An overview of these studies 14 showed a 15% excess risk of CHD in association with periodontal disease, with 95% confidence intervals ranging from 8% to 122%. To define the underlying mechanisms of such association, several studies, reviewed in depth by Armitage, 15 examined the potential link between periodontal disease and cardiovascular risk factors, including diabetes, smoking, hyperlipidemia, and hypertension. Surprisingly, despite the high prevalence of hypertension in the general population and its leading prognostic importance, few data are available on the relation between elevated blood pressure (BP), hypertensive organ damage, and periodontal disease. Castelli et al 16 found a proliferation of the intima and elastic layers with lumen reduction of vessels feeding the periodontal membrane in hypertensive subjects. 16 In another study, tooth position and movements were affected by the force of BP transmitted through periodontal vessels. 17 Interestingly, periodontal pulsation reflected changes in pulse pressure rather than in mean BP. 17 Left ventricular (LV) mass is abnormally increased in about one third of people with hypertension, 18 and LV hypertrophy is associated with an excess risk of cardiovascular complications independently of BP and oth...

Hypertension and periodontal status in Senegalese patients: A case-control study

“…For his part, Angeli used CPITN as an endpoint of periodontal disease to investigate the relationship between CPITN and left ventricular mass in patients with essential hypertension. He found a progressive increase in systolic and diastolic pressure from CPITN score 0 to 4 (p = 0.0001 and p = 0.05) [4]. These findings are comforting in that we found a significant relationship (p < 0.001) between CPITN and hypertension after a simple logistic regression, despite the fact that there is a highly significant relationship between tooth loss (p < 0.001) and hypertension, as mentioned in many studies.…”

“…Over 80% of deaths related to these diseases occur in low and middle income countries and affect all people regardless of age and sex [3]. Several risk factors such as smoking, diabetes, hypertension, obesity, dyslipidemia and physical inactivity, are described as being associated with the onset or worsening of cardiovascular diseases [4,5]. These same factors are also involved in the development and severity of periodontal disease [6,7].…”

“…Leite [9], in an experimental study on laboratory rats in Brazil in 2005 concluded that hypertension has a significant impact on worsening periodontal pocket depth. A cross-sectional study by Angeli et al in 2003 in Italy on the correlation between left ventricular mass and severity of periodontitis on 104 patients reported a direct association between these two parameters [4].…”

Relationship between General Health, Lifestyle, Oral Health, and Periodontal Disease in Adults: A Large Cross-sectional Study in Japan

“…Several studies 2,7,19,41,42) have reported a significant relationship between systolic blood pressure and periodontitis and have discussed …”

Periodontal and systemic health conditions of the patients treated in the student clinic of department of periodontology betweeen the years 2012-2014

“…44 Bu durumun damar duvarında kalın-laşmaya ve direnç artışına dolayısıyla yüksek kan basıncı-na neden olduğunu belirten çalışmalar mevcuttur. 45,46 Periodontal hastalık ile kardiyovasküler hastalık arasın-daki zayıf fakat istatistiksel olarak anlamlı ilişkiyi gösteren meta-analiz çalışmalarına dayanarak periodontitisli bireylerin kardiyovasküler hastalık gelişimi ya da ilerlemesinde daha büyük risk altında olduğu ve yine periodontitisin aterosklerotik damar hastalıkları için bilinen genel risk faktörlerinden (sigara içme, diabetes mellitus, obezite, genetik) bağımsız olarak tek başına önemli bir risk faktörü olduğu söylenebilir. [47][48][49] Nikolaos ve ark.…”