Periodontal Disease, Hypertension, and Blood Pressure Among Older Adults in Puerto Rico

Abstract

Background Current scientific evidence addressing the relation between periodontitis and hypertension is limited to a few studies producing inconsistent results. Methods All participants of an on-going representative cohort of Puerto Rican elderly who were 70 years and older and residing in San Juan metropolitan area were invited to this cross-sectional study. Periodontal probing depth (PD) and attachment loss (AL) were summarized using CDC-AAP definition for severe periodontitis (≥2 teeth with AL ≥6mm and ≥1 tooth with PD ≥5mm). We averaged three repeated blood pressure (BP) measurements taken using a standardized auscultatory method. Information on hypertension history, use of anti-hypertensive medications and potential confounders (age, gender, smoking, heavy and binge drinking, diabetes, utilization of preventive dental services, flossing, body mass index, fruit and vegetable, whole wheat bread and high-fiber cereal consumption) was collected during in-person interviews. High BP was defined as average systolic BP ≥140 mmHg or diastolic ≥90 mmHg. Multivariate logistic regression models were used to study the relation between severe periodontitis, hypertension history and high BP. Results The study population comprised 182 adults. In multivariate analysis, there was no association between severe periodontitis and hypertension history (OR=0.99, 95% CI: 0.40–2.48). Severe periodontitis was associated with high BP, with OR of 2.93 (95% CI: 1.25–6.84), after adjusting for age, gender, smoking, and binge drinking. This association was stronger when restricted to those with hypertension or taking anti-hypertensive medications: OR=4.20 (95% CI: 1.28–13.80). Conclusion Our results suggest that periodontitis may contribute to poor blood pressure control among older adults.

Association between hypertension status and the screening test for frailty in elderly community-dwelling Japanese

“…31 Moreover, periodontal disease is reported to contribute to poor BP control in subjects aged 70 years and older. 32 In the present study, specified BCF categories and/or items were newly identified as factors independently associated with prevalence of hypertension, untreated hypertension and BP-uncontrolled hypertension in elderly community-dwelling subjects. These frailty categories and items may be useful for evaluating hypertension status in elderly community-dwelling subjects.…”

Association of periodontitis with insulin resistance, β-cell function, and impaired fasting glucose before onset of diabetes

“…Equally both the prevalence of hypertension and dyslipidemia were higher in participants with periodontitis considering both overall participants and participants without diabetes. Although a previous study found no significant association between incidence of hypertension and periodontal diseases [41], severe and or chronic periodontitis may contribute to development of hypertension [42] because periodontal damage is a source of both inflammatory cytokines and markers, C-reactive protein (CRP) for instance [43].…”

Severe Periodontitis Is Inversely Associated with Coffee Consumption in the Maintenance Phase of Periodontal Treatment

“…Chi-square test or unpaired t -test were used to explore potential confounders for periodontitis severity [30,31,32]. Logistic regression analyses were performed with moderate/severe periodontitis and severe periodontitis as dependent variables.…”