Efficacy of screening for high blood pressure in dental health care

Abstract

BackgroundThere is consensus on the importance of early detection and treatment of high blood pressure. Dental care is one of few medical services to which a considerable proportion of the general population comes for regular check-ups. We tested the effects of blood pressure screening in dental care centres with subsequent work-up of subjects screening positive in primary health care (PHCC).MethodsAltogether 1,149 subjects 40-65 years old or 20-39 years old with body mass index >25, and with no previously known hypertension, who came for a dental examination had their blood pressure measured with an Omron M4® automatic blood pressure reading device. Subjects with systolic blood pressure readings above 160 mmHg or diastolic above 90 mmHg were referred to their PHCC for a check up. Outcome data were obtained by scrutiny of PHCC and hospital patient records for hypertension diagnoses during the three years following screening.Results237 (20.6%) subjects screened positive. Of these, 230 (97.1%) came to their PHCC within the 3-year follow-up period, as compared with 695 (76.2%) of those who screened negative (p < 0.0001). Of those who screened positive, 76 (32.1%) received a diagnosis of hypertension, as compared with 26 (2.9%) of those who screened negative. Sensitivity was 79.1%, specificity 84.8% and positive predictive value 30.1%. The number of subjects needed to screen to find one case of hypertension was 18.ConclusionsCo-operation between dental and primary care for blood pressure screening and work-up appears to be an effective way of detecting previously unknown hypertension.

Early Screening of Diabetes and Hypertension in Primary Care Dental Clinics at King Saud University in Riyadh, Kingdom of Saudi Arabia

“…9 A British study found that few dentists screened for high blood pressure, although more than 25% felt it was a good idea. 10 Early detection of the chronic condition can save more than 75% of the total cost of the treatment and decrease the chance of causing deaths by 70%. 9 According to the medical expenditure panel survey, only 10 to 20% of the adults have seen physician yearly, whereas about 40% of the adults visit the dentist on a yearly basis.…”

Trauma by iPad

“…4,6 Systemic considerations by dentists can be valuable additions to improving the nations' health, particularly in detecting asymptomatic conditions. 7 One example is Engström et al, 8 who excellently demonstrated the value of screening for hypertension in Sweden, and there seems to be no real reason why this effect could not be duplicated in the UK.…”

Diagnosis

“…Even though hypertension is the most commonly diagnosed disease worldwide, undiagnosed hypertension is still prevalent in various patient populations. The findings of one study concluded that 20% of the sample patient population examined had undiagnosed hypertension [3]. Therefore, the clinician has an important role in screening for hypertension.…”