Association between Periodontitis and High Blood Pressure: Results from the Study of Periodontal Health in Almada-Seixal (SoPHiAS)

Abstract

Periodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure (BP). This study aimed to explore (a) the association between periodontal health and BP in a large representative cohort, (b) the predictive value of diagnosis of periodontitis in undiagnosed raised BP and (c) whether age is a mediator of this relationship. In total, 1057 randomly recruited individuals (mean age, 60.9 ± 16.3 years, 57.7% women) underwent periodontal clinical assessment and one-single BP measurement using an automated sphygmomanometer device. Logistic and linear regression models were used to estimate the odds of hypertension based on periodontitis case definitions. Mediation analysis was performed to understand the effect of age on the association of periodontitis with hypertension. Adjusted logistic model for gender, smoking habits and body mass index confirmed the association between high BP and periodontitis (OR = 2.31, 95%CI: 1.75–3.04, p < 0.001). Among 168 participants with undiagnosed high BP (15.9% of the study sample), 62.5% had periodontitis (n = 105). In this study, the association between periodontitis with both systolic blood pressure (SBP) (77.6%, p < 0.001) and diastolic blood pressure (DBP) (66.0%, p < 0.001) was mediated by age. Periodontitis is closely linked to BP in a representative Portuguese population.

Vitamin D and Periodontitis: A Systematic Review and Meta-Analysis

“…Further, other factors such as seasonal variation [ 96 ], race and vitamin D binding protein [ 97 ] can also affect 25(OH)D levels. Likewise, periodontitis is also a relevant risk factor in these pathologies [ 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 ], and a potential mediation effect of periodontitis-vitamin D may be considered and further developed in clinical studies.…”

Blood Pressure and Tooth Loss: A Large Cross-Sectional Study with Age Mediation Analysis

“…In addition, uncontrolled hypertension may also precipitate stroke events and cognitive impairment, and it contributes to increased mortality rate [ 6 ]. Recently, high BP was associated with oral conditions, mainly tooth loss, caries and periodontal disease [ 7 , 8 , 9 , 10 , 11 , 12 ].…”

“…Several lines of evidence have addressed the association between tooth loss and high BP [ 4 , 8 , 9 , 12 ]. In a French cohort of people under 65 years old, hypertension was associated with higher levels of missing teeth, gum bleeding, masticatory dysfunction and dental plaque [ 19 ].…”

“…Furthermore, abnormal elevated systolic BP (SBP) levels were correlated with tooth loss in adults <60 years in a population-based study in Brazil [ 4 ]. Considering the interplay between hypertension and tooth loss, dental care appointments constitute an environment where BP is commonly measured and, therefore, might play a noteworthy responsibility in forwarding suspected undiagnosed hypertensive patients to seek proper care [ 8 ]. Exploring the association of both conditions and the levels of undiagnosed hypertensive patients in dental units would be of great public health interest.…”

Special Issue “Oral Health and Systemic Diseases”

“…Furthermore, the diagnostic potential of saliva in stroke is highlighted. Machado et al [ 7 ] included 1057 patients from the cohort of Study of Periodontal Health in Almada-Seixal (SoPHiAS), a Portuguese population-based cross-sectional study. The main objective of this investigation was the evaluation of associations between increased blood pressure and periodontitis.…”