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. 2020 Oct;38(10):2018-2027.
doi: 10.1097/HJH.0000000000002514.

Active gingival inflammation is linked to hypertension

Davide Pietropaoli  1 , Annalisa Monaco  1 , Francesco D'Aiuto  2 , Eva Muñoz Aguilera  2 , Eleonora Ortu  1 , Mario Giannoni  1 , Marta Czesnikiewicz-Guzik  3   4 , Tomasz J Guzik  5   6 , Claudio Ferri  7 , Rita Del Pinto  7
Affiliations

Active gingival inflammation is linked to hypertension

Davide Pietropaoli et al. J Hypertens. 2020 Oct.

Abstract

Background: Cardiovascular diseases (CVD) including hypertension, are characterized by underlying systemic inflammation. Periodontitis, which can impact the systemic inflammatory burden has recently been linked to high blood pressure (BP). However, the relationship of gingival bleeding, as an easily accessible marker of periodontal disorder, with hypertension, remains unclear.

Methods: Survey-based propensity score matching (PSM) incorporating major confounders shared between hypertension and periodontal diseases was applied to cross-sectional NHANES III data from 5396 adults at least 30 years old who underwent BP measurement and periodontal examination, identifying two matched groups with and without gingival bleeding. The association of bleeding gums with SBP (mmHg) and high/uncontrolled BP was then assessed with generalized additive models incorporating inflammatory markers. Stratification by periodontal status (healthy; gingivitis; stable periodontitis; unstable periodontitis) was performed. Variables importance was estimated using machine learning.

Results: Gingival bleeding (gingivitis; unstable periodontitis) was independently associated with +2.6 mmHg (P < 0.001) SBP compared with no bleeding (healthy periodontium; stable periodontitis), and with greater odds (OR = 1.42; 95% CI = 1.19-1.68; P < 0.001) of high/uncontrolled BP. Participants with unstable periodontitis had higher SBP than those with stable periodontitis (+2.1 mmHg; P < 0.001) or gingivitis (+5.3 mmHg; P < 0.001). Unstable periodontitis and gingivitis were consistently associated with increased risk of high/uncontrolled BP (OR = 1.65, 95% CI = 2.14-1.82; OR = 1.49, 95% CI = 1.22-1.82, respectively). Inflammatory markers allowed a maximum of 12% gain in the models' predictive power.

Conclusion: Gingival bleeding contributes to shaping the relationship between periodontal diseases and BP, but the burden represented by periodontitis is also crucial. Periodontal evaluation might be of importance in difficult to control hypertension.

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Comment in

  • Letter regarding periodontitis and hypertension.
    Bursztyn M. Bursztyn M. J Hypertens. 2021 Feb 1;39(2):382-383. doi: 10.1097/HJH.0000000000002719. J Hypertens. 2021. PMID: 33394861 No abstract available.
  • Reply.
    Pietropaoli D, Monaco A, D'Aiuto F, Aguilera EM, Ortu E, Giannoni M, Czesnikiewicz-Guzik M, Guzik TJ, Ferri C, Del Pinto R. Pietropaoli D, et al. J Hypertens. 2021 Feb 1;39(2):383. doi: 10.1097/HJH.0000000000002720. J Hypertens. 2021. PMID: 33394862 No abstract available.

References

    1. Piepoli MF, Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, et al. ESC Scientific Document Group. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: the Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37:23152381.
    1. Forouzanfar MH, Liu P, Roth GA, Ng M, Biryukov S, Marczak L, et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mmHg, 1990-2015. JAMA 2017; 317:165182.
    1. Banegas JR, Lopez-Garcia E, Dallongeville J, Guallar E, Halcox JP, Borghi C, et al. Achievement of treatment goals for primary prevention of cardiovascular disease in clinical practice across Europe: the EURIKA study. Eur Heart J 2011; 32:21432152.
    1. Del Pinto R, Pagliacci S, De Feo M, Grassi D, Ferri C. Italian Society of Hypertension and Federfarma. Prevalence of hypertension and associated cardiovascular risk factors among pharmacies customers: an Italian nationwide epidemiological survey. Eur J Prev Cardiol 2019; 2047487319851301doi: 10.1177/2047487319851301. [Epub ahead of print]. - DOI
    1. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology and the European Society of Hypertension. J Hypertens 2018; 36:19532041.

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