Longitudinal Association Between Periodontitis and the Risk of Hypertension

Abstract

Objectives Hypertension poses major public health challenge due to its association with increased risk of heart disease, chronic kidney disease, and death. The objective of this study is to evaluate the longitudinal association between periodontitis and risk of hypertension. Methods 540 participants free of diagnosed hypertension/prehypertension in the San Juan Overweight Adults Longitudinal Study (SOALS) and with complete 3-year follow-up data were included. Periodontitis was classified according to 2012 CDC/AAP definition. Participants were considered to have developed hypertension if they reported physician-diagnosed hypertension over the follow-up period or had average systolic blood pressure (SBP) ≥ 140 mm Hg or diastolic blood pressure (DBP) ≥ 90 mm Hg at follow-up. Participants free of diagnosed hypertension or prehypertension and normal BP at baseline (SBP < 120 mm Hg and DBP < 80 mm Hg) were considered to develop prehypertension if they had SBP between 120–139 mm Hg or DBP between 80–89 mm Hg at follow up. An additional (secondary) outcome was defined as the development of prehypertension/hypertension over the follow-up period among participants who had normal BP at baseline. We used Poisson regression adjusting for age, sex, smoking status, physical activity, alcohol intake, diabetes, waist circumference, and family history of hypertension. Results One hundred and six (19.6%) participants developed hypertension, and 58 of the 221 with normal BP (26%) developed prehypertension/hypertension. There was no consistent association between periodontitis and the risk of developing hypertension. However, people with severe periodontitis had an increased incidence of prehypertension/hypertension (multivariate IRR:1.47; 95% CI: 1.01, 2.17) than people without periodontitis, after adjusting for confounders. Conclusion There was no association between periodontitis and hypertension in this cohort study. However, severe periodontitis was associated with an increased risk of prehypertension/hypertension.

Longitudinal Association between Periodontitis and the Risk of Hypertension

“…This manuscript was submitted [ 25 ] as a pre-print in the link “ https://www.researchsquare.com/article/rs-1694860/v1 .”…”

“…The study was conducted using the San Juan Overweight Adults Longitudinal Study (SOALS), the design and methods have been described in detail in previous publications [8,18,[23][24][25]. SOALS recruited overweight and obese adults aged 40-65 free of physician diagnosed hypertension at baseline.…”

A novel nomogram for predicting risk of hypertension in US adults with periodontitis: National Health and Nutrition Examination Survey (NHANES) 2009–2014

“…[28] Another cohort study also showed that patients with severe periodontitis had a higher risk of hypertension (OR: 1.47, 95% CI:1.01-2.17) than those without periodontitis. [29] The mechanism between periodontitis and hypertension is mediated by inflammation, endothelial dysfunction and oxidative stress. [30] Of course, it has also been shown that endotoxemia, which can increase the risk of cardiometabolic abnormalities and the start of CVD, can be caused by metabolic abnormalities and high levels of circulating lipopolysaccharide in individuals with periodontitis.…”