P63 Periodontal health status is associated with daily blood pressure levels in adolescents with hypertension

Abstract

No routine bedside test measures cardiac index directly; the diagnosis of LCOS is currently made based on a number of clinical parameters including lactate, urine output and mixed venous saturations (svO 2 ).The efficacy of NIRS has been compared to these parameters in a number of studies.Averaged cerebral and renal NIRS <65% predict a lactate >3 mmol/L with a sensitivity of 95% and a specificity of 83% (p=0.0001, AUC 0.92).NIRS can detect the redistribution of blood flow occurring as a physiological response to low cardiac output states, assessed by analysing the difference between somatic (flank) and cerebral NIRS. A NIRS difference between somatic and cerebral NIRS of 10% is significant (p<0.001).NIRS also provides a robust indicator of renal dysfunction with an increased risk of doubling the creatinine level every hour the renal NIRS is <60% (p<0.001).Lower cerebral NIRS during the 60 minutes post bypass is associated with a lower psychomotor development index (PDI) of the Bayley Scales and haemosiderin foci on MRI. Further reports have evaluated the predictive value of NIRS on neurodevelopmental outcomes at two years of age, reporting that receptive communication may also be affected by the NIRS nadir.Sceptics refer to studies showing that NIRS values can be ascertained from inanimate objects, including root vegetables. This is not surprising since NIRS evaluates light absorption and even vegetables contain substances that can absorb and/or reflect specific wavelengths.Near-infrared spectroscopy is an exciting development in medical technology which provides the benfit of continuous, real-time, non-invasive monitoring at the bedside. It provides an adjunct to standard investigative modalities, correlating well with transcranial Doppler values and markers of tissue perfusion. NIRS can provide a useful indication that a change in regional blood flow has occurred and interventions performed in response to change in NIRS result in reduced morbidity.Aim To establish significant associations between periodontal health status, daily blood pressure (BP) profile and cardiovascular risk factors in adolescents with elevated BP. Materials and methods A cross-sectional study was conducted. We included 113 adolescents (78 boys) of 10-17 years whose BP level, after repeated office measurements, was at !95th percentile for this age group, height and sex, or !140/90 mmHg in adolescents over 16 years. All adolescents underwent 24-hour blood pressure monitoring, blood tests (lipid profile, fasting glucose, levels of uric acid, ALT and AST), echocardiography (left ventricular mass index, relative wall thickness), anthropometric measurements with BMI calculation, Tanner staging, dental examination (complex dental plaque index, oral hygiene index). We used univariate and multiple regression analyses to evaluate the associations between periodontium state and cardiovascular risk factors (adjusted to sex, age, Tanner stage, BMI, oral hygiene index).Results Clinical signs of periodontitis were observed in 32.7% of adolescents. At th...