Hypertension and periodontitis: A joint report by the Italian society of hypertension (SIIA) and the Italian society of periodontology and implantology (SIdP)

Abstract

An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low‐grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy‐Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low‐grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre‐hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health.

Association of periodontitis, missing teeth, and oral hygiene behaviors with the incidence of hypertension in middle‐aged and older adults in Korea: A 10‐year follow‐up study

“…The significant effect of toothbrushing frequency was supported by two cross‐sectional studies among 101,209 Japanese middle‐aged adults and 19,560 Korean adults 23,24 . Low‐grade intraoral inflammation has a causal role in the future occurrence of hypertension, and effective oral care may reduce the risk 42 …”

“…23,24 Low-grade intraoral inflammation has a causal role in the future occurrence of hypertension, and effective oral care may reduce the risk. 42 The final model in Table 2 was adjusted for all covariates but did not adopt mutual adjustment for oral healthrelated independent variables that could have complex inter-relationships. Periodontitis status may affect the number of missing teeth, and they both may affect oral hygiene factors.…”

“…45 Studies on the effect of periodontal treatment indicated a parallel improvement in systemic inflammatory markers and blood pressure profile after treatment. 42 Although the majority of previous cross-sectional studies have supported the significant association between periodontitis and hypertension, 18 longitudinal evidence assessing the incidence of hypertension in relation to periodontitis is limited. To the best of our knowledge, only four cohort studies related to this topic have been conducted, and two of which have used self-reported definitions of periodontal status and/or hypertension.…”

Access to dental care and blood pressure profiles in adults with high socioeconomic status

“…Thus, cardiovascular prevention strategies might benefit from a comprehensive approach that includes timely dental visits. 49 Future clinical trials on hypertension, as well as the clinical practice, might benefit from systematically assessing information on oral health status and access to dental care.…”

“…In conclusion, access to dental care assessed by the timing of dental visits is related to BP profiles, possibly through systemic inflammation. Thus, cardiovascular prevention strategies might benefit from a comprehensive approach that includes timely dental visits 49 . Future clinical trials on hypertension, as well as the clinical practice, might benefit from systematically assessing information on oral health status and access to dental care.…”