Impact of Nonsurgical Periodontal Treatment on Blood Pressure: A Prospective Cohort Study

Abstract

Objectives: Arterial hypertension and periodontitis are two of the most common diseases worldwide and recent evidence supports a causal relationship between them. Despite all antihypertensive strategies, an important number of patients are undiagnosed and a large number of the diagnosed fail to achieve optimal blood pressure (BP) measurements. Some studies point out that periodontal treatment could have positive effects on BP levels. The aim of this study is to determine if nonsurgical periodontal treatment can help BP level control in prehypertensive patients with periodontitis.

Materials and methods: Thirty-five patients were included in the study and received nonsurgical periodontal treatment according to necessity. Clinical data, periodontal data, and BP measurements were taken at baseline, periodontal re-evaluation visit (4-6 weeks after treatment), and 6-month follow-up.

Results: Periodontal treatment caused a statistically significant reduction (p < 0.05) of systolic blood pressure (SBP) and diastolic blood pressure (DBP) at re-evaluation visit of 4.7 (p = 0.016) and 3.4 mm Hg (p = 0.015), respectively. The effect was maintained at 6-month follow-up visit with a reduction in SBP and DBP of 5.2 (p = 0.007) and 3.7 (p = 0.003) mm Hg, respectively.

Conclusion: Despite the limitations of this study, it suggests that nonsurgical periodontal treatment can be effective in lowering BP levels in patients with prehypertension and periodontitis. Moreover, it highlights the importance of dentists in prevention, detection, and control of this important cardiovascular risk factor.

Fig. 1

Flow diagram of patient inclusion and exclusion.

Fig. 2

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) during 6-month follow-up period. Parts A and B represent mean SBP and mean DBP, respectively. Vertical bars represent standard deviation (SD). p -Values were calculated with paired samples Student's t-test between baseline and re-evaluation visit and between baseline and 6-month follow-up visit.

Fig. 3

Histogram of blood pressure (BP) distribution. Parts A and B represent changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) distribution, respectively, between baseline and periodontal re-evaluation visit. Parts C and D represent changes in SBP and DBP distribution, respectively, between baseline and 6-month follow-up visit. Vertical lines represent BP mean values of each visit.

Fig. 4

Relationship between periodontal parameters (probing pocket depth, PPD [mm], clinical attachment loss, CAL [mm], bleeding on probing, BOP [%]) and systolic blood pressure (SBP) and diastolic blood pressure (DBP; mm Hg) measurements (left and right column, respectively). Baseline values are presented in blue and 6-month follow-up values are presented in green.