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DALLAS, October 22, 2018 - People with high blood pressure who take medications for their condition are more likely to benefit from therapy if they have good oral health, according to new research in the American Heart Association journal Hypertension.
The analysis findings, based on a review of medical and dental exam records of more than 3,600 people with high blood pressure, reveal that people with healthier gums have lower blood pressure and responded better to blood pressure-lowering medications. blood pressure, compared to people who have gum disease, a condition known as periodontitis .
Specifically, people with periodontal disease were 20 percent less likely to achieve healthy blood pressure levels, compared to patients with good oral health.
Given the findings, the researchers say patients with periodontal disease may require closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, could benefit from a referral to a dentist.
"Physicians should pay close attention to the oral health of patients, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care," Pietropaoli said.
"Dental health should know that oral health is essential for general physiological health, including cardiovascular status"
"Likewise, dental health professionals should know that oral health is indispensable for overall physiological health, including cardiovascular status," said the study’s principal investigator, Davide Pietropaoli, DDS, Ph.D., of the University of L’Aquila in Italy.
The target blood pressure range for people with hypertension is less than 130/80 mmHg according to the most recent recommendations from the American Heart Association/American College of Cardiology. In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health.
Systolic pressure, the top number in a blood pressure reading, indicates the pressure of blood against the walls of your arteries. While it appears to be small, the 3 mmHg difference is similar to the blood pressure reduction that can be achieved by reducing salt intake by 6 grams per day (equivalent to one teaspoon of salt, or 2.4 grams of sodium ), the researchers said.
The presence of periodontal disease widened the gap even further, up to 7 mmHg, among people with untreated hypertension, according to the study. Blood pressure medication reduced the gap to 3 mmHg, but did not eliminate it completely, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.
"Patients with high blood pressure and the doctors who care for them should be aware that good oral health may be as important in managing the disease as various lifestyle interventions that help control blood pressure, such as a low in salt, regular exercise and weight control,” said Pietropaoli.
While the study was not designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research linking low-grade oral inflammation with blood vessel damage and cardiovascular risk.
It is estimated that hypertension affects up to 40 percent of people over the age of 25 worldwide.
Untreated or poorly controlled hypertension can lead to heart attacks, strokes, and heart failure, as well as kidney disease. Hypertension is estimated to claim 7.5 million lives worldwide.
Gums that are red, swollen, and tender or that bleed with brushing and flossing are telltale signs of inflammation and periodontal disease. The same goes for teeth that appear longer than before, a sign of receding gums, and teeth that are loose or separated from the gum line.
Co-authors of the research included Rita Del Pinto, MD, PhD candidate; Claudio Ferri, MD.; Mario Giannoni, MD, DDS.; Eleonora Ortu, DDS, Ph.D.; and Annalisa Moaco, DDS, M.Sc., from the University of L’Aquila, Italy; and Jackson Wright Jr., M.D., Ph.D., of Case Western Reserve University.
