Practical Guidelines for Patients with Hypertension and Periodontitis

Davide Pietropaoli^{1

2}, Francesco Cairo³, Filippo Citterio⁴, Francesco D'Aiuto⁵, Claudio Ferri⁶, Guido Grassi^{7

8}, Luca Landi⁹, Claudio Letizia¹⁰, Stefano Masi^{11

12}, Maria Lorenza Muiesan^{13

14}, Guerino Paolantoni¹⁵, Nicola Marco Sforza^{16

17}, Rita Del Pinto^{2

18}; Italian working group on Hypertension and Periodontitis (Hy-Per Group)

Affiliations

¹ Unit of Oral Diseases, Prevention and Translational Research, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, Dental Clinic, University of L'Aquila, L'Aquila, Italy.
² School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
³ Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
⁴ Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
⁵ Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.
⁶ Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. claudio.ferri@univaq.it.
⁷ Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy.
⁸ President of the European Society of Hypertension, Milan, Italy.
⁹ Private Practice, Via della Balduina, 114, 00136, Rome, Italy. lulandi1@gmail.com.
¹⁰ Unit of Secondary Arterial Hypertension, Department of Clinical, Internal Medicine, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, 00161, Rome, Italy.
¹¹ Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
¹² Institute of Cardiovascular Science, University College London, and the National Institute for Health Research University College London Biomedical Research Centre, London, UK.
¹³ Department of Clinical and Experimental Sciences, Center for Hypertension Prevention and Management, University of Brescia and ASST Spedali Civili, Brescia, Italy.
¹⁴ President of The Italian Society of Hypertension (SIIA), Milan, Italy.
¹⁵ Private Practice, Naples, Italy.
¹⁶ President of The Italian Society of Periodontology and Implantology (SIdP), Florence, Italy.
¹⁷ Private Practice, Bologna, Italy.
¹⁸ Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.

PMID: 36607561
PMCID: PMC9908625
DOI: 10.1007/s40292-022-00553-2

Practical Guidelines for Patients with Hypertension and Periodontitis

Davide Pietropaoli et al. High Blood Press Cardiovasc Prev. 2023 Jan.

. 2023 Jan;30(1):7-16.

doi: 10.1007/s40292-022-00553-2. Epub 2023 Jan 6.

Authors

Affiliations

¹ Unit of Oral Diseases, Prevention and Translational Research, Department of Life, Health and Environmental Sciences, San Salvatore Hospital, Dental Clinic, University of L'Aquila, L'Aquila, Italy.
² School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
³ Research Unit in Periodontology and Periodontal Medicine, Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy.
⁴ Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
⁵ Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.
⁶ Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy. claudio.ferri@univaq.it.
⁷ Department of Medicine and Surgery, Clinica Medica, University of Milano-Bicocca, Milan, Italy.
⁸ President of the European Society of Hypertension, Milan, Italy.
⁹ Private Practice, Via della Balduina, 114, 00136, Rome, Italy. lulandi1@gmail.com.
¹⁰ Unit of Secondary Arterial Hypertension, Department of Clinical, Internal Medicine, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, 00161, Rome, Italy.
¹¹ Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
¹² Institute of Cardiovascular Science, University College London, and the National Institute for Health Research University College London Biomedical Research Centre, London, UK.
¹³ Department of Clinical and Experimental Sciences, Center for Hypertension Prevention and Management, University of Brescia and ASST Spedali Civili, Brescia, Italy.
¹⁴ President of The Italian Society of Hypertension (SIIA), Milan, Italy.
¹⁵ Private Practice, Naples, Italy.
¹⁶ President of The Italian Society of Periodontology and Implantology (SIdP), Florence, Italy.
¹⁷ Private Practice, Bologna, Italy.
¹⁸ Unit of Internal Medicine and Nephrology, Department of Life, Health and Environmental Sciences, Center for Hypertension and Cardiovascular Prevention, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy.

PMID: 36607561
PMCID: PMC9908625
DOI: 10.1007/s40292-022-00553-2

Abstract

Arterial hypertension (AH) and periodontitis are among the most common non-communicable chronic diseases worldwide. Besides sharing common risk factors, an increasing body of evidence supports an independent association between the two conditions, with low-grade systemic inflammation acting as the plausible biological link with increased cardiovascular risk. In 2021, the Italian Society of Arterial Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) have joined forces and published a joint report on the relationships between AH and periodontitis, reviewing the existing scientific evidence and underlining the need to increase awareness of the strong connection between the two conditions and promote treatment strategies for the control of gums inflammation in patients with AH. The current document extends the previous joint report, providing clinical practical guidelines aimed to support clinicians in the management of patients who suffer from or are at risk of being affected by both conditions. These recommendations are based on careful consideration of the available evidence as well as of the current guidelines on the management of periodontitis and AH and are supported by SIIA and SIdP.

Keywords: Hypertension; Periodontitis; Practice guidelines.

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Conflict of interest statement

The Authors declare no conflicts of interest.

Figures

**Fig. 1**
Integrated care pathways for the management of patients with AH with or at risk for gingivitis/periodontitis

**Fig. 2**
Integrated care pathways for the management of patients with gingivitis/periodontitis with or at risk for AH

See this image and copyright information in PMC

References

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1. Del Pinto R, Landi L, Grassi G, Sforza NM, Cairo F, Citterio F, et al. Hypertension and periodontitis: a joint report by the Italian Society of Hypertension (SIIA) and the Italian Society of Periodontology and Implantology (SIdP) High Blood Press Cardiovasc Prev. 2021;28:427–438. doi: 10.1007/s40292-021-00466-6. - DOI - PMC - PubMed
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1. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89(Suppl 1):S159–S172. doi: 10.1002/JPER.18-0006. - DOI - PubMed

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Practical Guidelines for Patients with Hypertension and Periodontitis

Affiliations

Practical Guidelines for Patients with Hypertension and Periodontitis

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical