Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Sep;28(5):427-438.
doi: 10.1007/s40292-021-00466-6. Epub 2021 Sep 25.

Hypertension and Periodontitis: A Joint Report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP)

Rita Del Pinto  1 , Luca Landi  2 , Guido Grassi  3 , Nicola Marco Sforza  4 , Francesco Cairo  5 , Filippo Citterio  6 , Guerino Paolantoni  7 , Francesco D'Aiuto  8 , Claudio Ferri  9 , Annalisa Monaco  10 , Davide Pietropaoli  10 ; Italian working group on Hypertension, Periodontitis (Hy-Per Group)
Affiliations
Review

Hypertension and Periodontitis: A Joint Report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP)

Rita Del Pinto et al. High Blood Press Cardiovasc Prev. 2021 Sep.

Abstract

An accumulating body of evidence supports an independent association between high blood pressure (BP) and periodontitis, possibly mediated by low-grade inflammation. This joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) working group on Hypertension and Periodontitis (Hy-Per Group) provides a review of the evidence on this topic encompassing epidemiology, biological plausibility, relevance, magnitude, and treatment management. Consensus recommendations are provided for health professionals on how to manage BP in individuals showing signs of poor oral health. In summary, (1) large epidemiological studies highlight that individuals with periodontal diseases have increased risk for high/uncontrolled BP independent of confounders; (2) mechanistically, low-grade inflammation might have a causal role in the association; (3) BP profile and control might benefit from periodontal treatment in pre-hypertensive and hypertensive individuals; (4) oral health status should be evaluated as a potential risk factor for high/uncontrolled BP, and effective oral care should be included as an adjunct lifestyle measure during hypertension management. Further research is needed to optimize BP management in individuals with poor oral health.

Keywords: Cardiovascular diseases; Hypertension; Inflammation; Periodontitis; Risk factors.

PubMed Disclaimer

Conflict of interest statement

On behalf of all authors, the corresponding authors state that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Effect of periodontal treatment on systolic BP in pre-hypertensive and hypertensive individuals. A meta-regression between post-intervention BoP change (mean difference [MD]; %) and systolic BP (MD, mmHg). B meta-regression between post-intervention PPD change (MD; mm) and systolic BP (MD, mmHg). Regression slopes reflect the effect of periodontal treatment on BP in pre-hypertensive and hypertensive individuals. Data were extracted from studies included in the meta analysis by Sharma et al. [47] and the meta-regression is an original figure by the Hyper-Group. Heterogeneity was reported among studies
See this image and copyright information in PMC

References

    1. Giampaoli S, Vescio MF, Gaggioli A, Vanuzzo D, [on behalf of the Research Group of the Observatory for Cardiovascular Epidemiology]. Prevalence of Arterial Hypertension in the Italian Population. Istituto Superiore di Sanità. 2021. https://www.epicentro.iss.it/ben/2002/settembre02/2_en. Accessed 1 May 2021.
    1. Aimetti M, Perotto S, Castiglione A, Mariani GM, Ferrarotti F, Romano F. Prevalence of periodontitis in an adult population from an urban area in North Italy: findings from a cross-sectional population-based epidemiological survey. J Clin Periodontol. 2015;42:622–631. doi: 10.1111/jcpe.12420. - DOI - PubMed
    1. Loos BG, Van Dyke TE. The role of inflammation and genetics in periodontal disease. Periodontol. 2000;2020(83):26–39. - PMC - PubMed
    1. Del Pinto R, Pietropaoli D, Munoz-Aguilera E, D’Aiuto F, Czesnikiewicz-Guzik M, Monaco A, et al. Periodontitis and hypertension: is the association causal? High Blood Press Cardiovasc Prev. 2020;27:281–289. doi: 10.1007/s40292-020-00392-z. - DOI - PubMed
    1. Czesnikiewicz-Guzik M, Osmenda G, Siedlinski M, Nosalski R, Pelka P, Nowakowski D, et al. Causal association between periodontitis and hypertension: evidence from Mendelian randomization and a randomized controlled trial of non-surgical periodontal therapy. Eur Heart J. 2019;40:3459–3470. doi: 10.1093/eurheartj/ehz646. - DOI - PMC - PubMed