The additive effect of periodontitis with hypertension on risk of systemic disease and mortality

Larvin, Harriet; Kang, Jing; Aggarwal, Vishal R.; Pavitt, Sue; Wu, Jianhua

doi:10.1002/jper.21-0621

Cited by 15 publications

(7 citation statements)

References 33 publications

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“…Our findings are consistent with earlier evidence that periodontitis increased the risk of all-cause mortality in the older population in Sweden and Denmark and in hypertensive patients (Hansen et al 2016; Bengtsson et al 2021; Larvin et al 2022). Nevertheless, it is not easy to compare these studies, as they applied slightly different definitions for periodontitis.…”

Section: Discussionsupporting

confidence: 93%

Does Periodontitis Affect the Association of Biological Aging with Mortality?

Liu

Cai

et al. 2023

J Dent Res

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The prevalence of periodontitis is increasing with the aging of the global population. Periodontitis has been suggested to accelerate aging and increase mortality. The present nationwide prospective cohort study aimed to determine whether periodontitis could modify the association of biological aging with all-cause and cause-specific mortality in middle-aged and older adults. Participants ≥40 y of age from the Third National Health and Nutrition Examination Survey (NHANES III) were included ( n = 6,272). Phenotypic age acceleration (PhenoAgeAccel) was used to evaluate the biological aging process. Moderate/severe periodontitis was defined using a half-reduced Centers for Disease Control and Prevention and American Academy of Periodontology case definition. Multivariable Cox proportional hazard regression was conducted to estimate the association between PhenoAgeAccel and mortality risk, followed by effect modification analysis to test whether periodontitis modified the association. During a median follow-up of 24.5 y, 3,600 (57.4%) deaths occurred. The positive relationships between PhenoAgeAccel and all-cause and cause-specific mortality were nonlinear. After adjusting for potential confounders, the highest quartile of PhenoAgeAccel was associated with increased all-cause mortality in individuals with no/mild periodontitis (hazard ratio for Q4 vs. Q1 [HRQ4vs.Q1] = 1.789; 95% confidence interval [CI], 1.541–2.076). In contrast, the association was enhanced in patients with moderate/severe periodontitis (HRQ4vs.Q1 = 2.446 [2.100–2.850]). Periodontal status significantly modified the association between PhenoAgeAccel and all-cause mortality ( P for interaction = 0.012). In subgroup analyses, the modifying effect of periodontitis was observed in middle-aged adults (40–59 y), females, and non-Hispanic Whites. Although cause-specific mortality showed a similar trend, the PhenoAgeAccel × periodontitis interaction did not reach statistical significance. In conclusion, periodontitis might enhance the association of biological aging with all-cause mortality in middle-aged and older adults. Hence, maintaining and enhancing periodontal health is expected to become an intervention to slow aging and extend life span.

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Section: Discussionsupporting

confidence: 93%

Does Periodontitis Affect the Association of Biological Aging with Mortality?

Liu

Cai

et al. 2023

J Dent Res

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“…These conditions can induce a state of systemic inflammation, which is in line with what Ramadan et al (2020), and Passarelli et al (2020), have concluded on the given topic [ 48 , 49 ]. The bioactive molecules released during this chronic low-grade inflammation, such as cytokines, can adversely affect vascular endothelial function, setting the stage for increased arterial stiffness and hypertension [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Role of oral health in heart and vascular health: A population-based study

Ghanem,

Németh,

Móré

et al. 2024

PLoS ONE

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Background and aim Conditions such as hypertension, cardiovascular diseases, and hypercholesterolemia, are a major public health challenge. This study investigates the influence of oral health indicators, including gum bleeding, active dental caries, tooth mobility, and tooth loss, on their prevalence in Hungary, considering socioeconomic, demographic, and lifestyle factors. Materials and methods Data from the 2019 Hungarian European Health Interview Survey with 5,603 participants informed this analysis. Data were accessed from the records maintained by the Department of Health Informatics at the University of Debrecen between September and November 2023. Variable selection employed elastic net regularization and k-fold cross-validation, leading to high-performing predictors for weighted multiple logistic regression models. Sensitivity analysis confirmed the findings’ validity. Results Significant links were found between poor oral health and chronic cardiac conditions. Multiple teeth extractions increased hypertension risk (OR = 1.67, 95% CI: [1.01–2.77]); dental prosthetics had an OR of 1.45 [1.20–1.75]. Gum bleeding was associated with higher cardiovascular disease (OR = 1.69 [1.30–2.21]) and hypercholesterolemia risks (OR = 1.40 [1.09–1.81]). Conclusions Oral health improvement may reduce the risk of cardiac conditions. This underscores oral health’s role in multidisciplinary disease management.

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“…Hypertension is independently associated with multi-morbidity [21]. Furthermore, hypertensive patients with periodontitis have an increased risk of several systemic diseases, especially CVD and respiratory disease [22]. The recognized association between periodontitis and hypertension, and the possibilities for interventions are essential considering the high prevalence of both diseases and increased societal burden of underdiagnosed and undertreated periodontitis.…”

Section: Discussionmentioning

confidence: 99%

Severity and progression rate of periodontitis are associated with an increased risk of hypertension of patients attending a university clinic

et al. 2022

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Background Although periodontitis is associated with increased risk of hypertension, studies based on new periodontal disease classification is limited. We investigated whether periodontitis severity and progression rate are linked with self-reports on doctor-diagnosed hypertension in a large cohort of patients attending the periodontology clinic at the faculty of dentistry. Methods Archived patient files, including radiographic image records and results from full-mouth clinical periodontal examination were screened for inclusion. Data on socioeconomic factors, smoking and oral hygiene habits, and medical history were collected with a questionnaire. Results Diagnosis and background data were available for 7008 patients. The median (IQR) age was 31.0 (21.0) years; 60.1% (n = 4211) were female. Hypertension was diagnosed in 6.2% (n = 435) of patients. Both periodontitis stage and grade differed (p < 0.001) between patients with or without hypertension. Increased periodontal disease severity was associated with a 20% increasing risk for hypertension; the odds ratio (OR) was 2.63 (95% confidence interval [CI] 1.48–4.68, p < 0.001) in stage IV periodontitis. Increasing periodontitis progression rate was associated with a 35% increased risk for hypertension; the OR was 2.22 (95% CI 1.45–3.40, p < 0.001) in grade C periodontitis. Conclusion Severity and progression rate of periodontitis may be independent risk factors for hypertension in this large cohort of patients attending the university periodontal department.

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The additive effect of periodontitis with hypertension on risk of systemic disease and mortality

Cited by 15 publications

References 33 publications

Does Periodontitis Affect the Association of Biological Aging with Mortality?

Does Periodontitis Affect the Association of Biological Aging with Mortality?

Role of oral health in heart and vascular health: A population-based study

Severity and progression rate of periodontitis are associated with an increased risk of hypertension of patients attending a university clinic

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