A new meta-study confirms a link between periodontal disease and high blood pressure and found that the poorer the oral health, the higher the risk of high blood pressure. The direction of the relationship remains unclear, and researchers are uncertain whether improved dental treatment may have a direct impact on blood pressure.
The meta-analysis collects data from 81 studies in 26 countries and confirms findings that suggest a large number of previous studies. A positive linear relationship was detected between periodontitis or gingival disease and the risk of hypertension. Moderate periodontitis was associated with a 22% increase in the risk of hypertension, while severe periodontitis was associated with a 49% increase in the risk of developing the condition.
“There is a linear association. The more severe the periodontitis, the more likely it is to have high blood pressure,” explains Francesco Dout, lead author at the University College London. "In healthy and illness, there seems to be a continuity between oral health and blood pressure."
The conclusions of the meta-study are fairly definitive, but many questions remain unanswered about the underlying mechanism of this association and whether aggressive treatment of periodontitis can lower blood pressure.
The meta-study included 12 intervention trials examining the relationship between periodontal treatment and blood pressure, but the results were certainly unconvincing. Only five of the intervention trials showed that treatment with periodontal disease caused an improvement in blood pressure.
"The evidence that periodontal treatment can lower blood pressure is unconvincing. Blood pressure was not the most important result in almost all intervention studies," says D'Aiuto. "The test must be canceled to determine the effect of periodontal treatment on blood pressure."
Researchers envision several mechanisms to explain the connection. One suggestion is that periodontitis can be mediated by similar inflammatory causes that also affect endothelial function. If this hypothesis is correct, treatment of severe periodontitis may reduce systemic inflammation and have beneficial effects on hypertension.
Another hypothesis is that bacteria in the oral microbiome can be involved in periodontitis and cause certain types of vascular dysfunction. This hypothesis is interestingly supported by recent studies that have discovered that bacteria in the mouth can be swallowed and then produce molecules that affect blood pressure.
Of course, researchers suggest that more research is needed to better understand the causal relationship, but in the short term, oral hygiene can help identify patients at risk of hypertension. It suggests that it may be a good biomarker.
"The findings suggest that patients with periodontal disease need to be informed about their risks and advised on lifestyle changes to prevent high blood pressure, such as exercise and a healthy diet," DAiuto said. Mr. says.
Although a link has been found between periodontal disease and high blood pressure, researchers are still uncertain whether improving oral health can improve a person's blood pressure.
Research published in the journal Cardiovascular Research.