Prevalence of hypertension and correlation with mental health in women with burning mouth syndrome: A case-control study

Abstract

BackgroundThe relationship between hypertension (HTN) and chronic pain is still a matter of debate, and its prevalence in patients with burning mouth syndrome (BMS) has never been evaluated. This study aimed to assess the prevalence of HTN in women with BMS and to evaluate its relationship with potential predictors such as risk factors for cardiovascular diseases, pain, and mental health status analyzing differences with healthy women.MethodsIn total, 250 women with BMS (WBMS) were prospectively recruited and compared with an equal number of healthy women (HW) matched for age. Education, body mass index, smoke and alcohol consumption, intensity and quality of pain, and psychological profile were further investigated to identify the potential predictors of HTN. Specifically, pain assessment [the Numeric Rating Scale (NRS) and Short-Form McGill Pain Questionnaire (SF-MPQ)] and psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS)] was carried out for the participants.ResultsHTN was found in 128 (51.2%) WBMS and 76 (30.4%) HW (p < 0.001**). The scores of the NRS, SF-MPQ, HAM-D, HAM-A, and PSQI were statistically significantly higher in the WBMS than in the HW (p < 0.001**). A strongly linear correlation between HTN and employment status, systemic diseases, and education level (p < 0.001**) was found in WBMS, while a strong correlation between HTN and employment status, hypercholesterolemia, systemic diseases, and drug consumption was found in HW (p < 0.001**). No statistically significant correlation was found between HTN and pain, anxiety, depression, and sleep disturbances.ConclusionThese results suggest that WBMS showed a higher prevalence of HTN compared with controls. Unemployed WBMS with lower education and other systemic comorbidities are at an increased risk of developing HTN. HTN is associated with alteration in the vascular structure and function of the brain, and these processes accelerate brain aging, which contributes to a reduction in intracortical connectivity, thus affecting the modulatory system of control of pain in patients with BMS, independently of their mental health assessment. Predictors that may underlie this association remain unclear, taking into account the differences found in HW, and should be further elucidated.

Non-Communicable Diseases and Associated Risk Factors in Burning Mouth Syndrome Patients

“…In our study, the presence of HT in the BMS group was 84.8%, which is consistently higher than the frequency identified in studies conducted in other countries. For example, Adamo and collaborators reported a HT frequency of 55% in BMS Italian patients [17], with a lower frequency of 51.2% considering only the female patients [18]. In line with our results, these authors also found a significantly higher frequency of HT in BMS patients compared to controls [17,18].…”

“…A larger study conducted in Italy, involving over 200 patients and 200 controls, has found a statistically significant higher proportion of BMS patients suffering from hypertension compared to controls [17]. The same group of authors analyzing a cohort of BMS women compared to not-affected women found that, in addition to hypertension, hypercholesterolemia was more frequent in the BMS women [18]. Another report on the Japanese population, investigating the prevalence of 13 diseases in BMS patients, found that most of the investigated diseases seemed to have little influence on the majority of patients with BMS [19].…”

“…The NCDs and the risk factors associated with BMS have not been deeply investigated, with only a few studies conducted in different populations [16][17][18]. A case-control study on a Spanish cohort reported that in general, BMS patients suffer more comorbidities than controls, mainly represented by mental, behavioral, and neurodevelopmental disorders [16].…”

Neuropsychological assessment of Romanian burning mouth syndrome patients: stress, depression, sleep disturbance, and verbal fluency impairments

“…The data on depression are in line with those reported in the literature. Indeed, many research groups reported higher levels of depression in BMS patients compared to controls measured by HADS ( Malik et al, 2012 ; Lopez-Jornet et al, 2015 ; Leuci et al, 2022 ) and other instruments, including HAM-D ( Nasreddine et al, 2005 ; Canfora et al, 2021 , 2023 ) and the Beck Depression and Anxiety Inventory (BDI) ( Buljan et al, 2008 ; Malta et al, 2021 ). In addition, in agreement with literature data ( Chainani-Wu et al, 2011 ; Adamo et al, 2013 ; Lopez-Jornet et al, 2015 ; Adamo et al, 2018 ; Rezazadeh et al, 2021 ), our outcomes confirmed a higher frequency of poor sleep quality in BMS patients than controls.…”

Editorial: Women in hypertension

“…A particular condition that requires special attention from physicians is preeclampsia, the leading cause of maternal and neonatal death, for which an early diagnosis and a timely initiated and well-conducted antihypertensive therapy are essential (25-27). With the sole exception of pregnancy, the current good clinical practice guidelines do not make any differences between men and women regarding the general therapeutic approach (28), even if a gender-related response to therapy has been suggested (29)(30)(31).…”