Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis
Open accessAbstract
Aim Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. Materials and methods A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). Results The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was -4.3 mmHg [95%CI: -9.10-0.48], p = 0.08 and -3.16 mmHg [95%CI: -6.51-0.19], p = 0.06 respectively. These studies were characterized by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD = -11.41 mmHg (95%CI: -13.66, -9.15) P < 0.00001] and DBP [WMD = -8.43 mmHg (95%CI: -10.96,-5.91)P < 0.00001] after IPT vs CPT among prehypertensive/hypertensive patients, while this was not observed in normotensive individuals. The meta-analyses showed significant reductions in CRP and improvement of endothelial function following IPT at all analysed timepoints. Conclusions IPT leads to improvement of the cardiovascular health in hypertensive and prehypertensive individuals.
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The majority of previously relevant meta-analyses only included periodontitis patients with specific systemic health conditions, such as CVD, CAD, hypertension and diabetes.
“In contrast, the majority of previously relevant meta analyses only included periodontitis patients with specific systemic health conditions, such as CVD [75], CAD [76], hypertension [77] and diabetes [78].”
From Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis (2024) · cites this paper as [77]
A previous meta-analysis found NSPT unrelated to improvements in LDL, HDL-C, TC, and TG levels.
“A previous meta-analysis [75, 77] found that, NSPT would appear unrelated to improvements in LDL, HDL-C, TC, and TG levels, consistent with our findings.”
From Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis (2024) · cites this paper as [77]
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ROBIS: A new tool to assess risk of bias in systematic reviews was developed
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Association between periodontitis and arterial hypertension: a systematic review and meta-analysis
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Meng, R., Xu, J., Fan, C., Liao, H., Wu, Z., & Zeng, Q. (2024) · BMC Oral Health · doi:10.1186/s12903-024-04433-0 · Cited by 26 · see citing works
“In contrast, the majority of previously relevant meta analyses only included periodontitis patients with specific systemic health conditions, such as CVD [75], CAD [76], hypertension [77] and diabetes [78].”
Result
- Authors
- Sharma, S., Sridhar, S., McIntosh, A., Messow, C.-M., Aguilera, E. M., Del Pinto, R., Pietropaoli, D., Gorska, R., Siedlinski, M., Maffia, P., Tomaszewski, M., Guzik, T. J., D’Aiuto, F., & Czesnikiewicz-Guzik, M.
- Affiliations
- University of Glasgow (GB)
- University of L'Aquila (IT)
- University of Naples Federico II (IT)
- University of Manchester (GB)
- Jagiellonian University (PL)
- University College London (GB)
- ORCID
- Venue
- Pharmacological Research
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 166
- Pages
- 105511
- ISSN
- 1043-6618 (ISSN-L)
- OpenAlex
- W3130660939
- Cited by
- 53
- References
- 10
- Citations by year
- 2026: 10 · 2025: 7 · 2024: 13 · 2023: 8 · 2022: 7 · 2021: 8
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- eprints.gla.ac.uk
- Licence
- Locations
- Pharmacological Research (publishedVersion)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Homo Politicus (Academy of Humanities and Economics in Lodz) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Keywords
- periodontal treatment, hypertension, subgingival instrumentation, blood pressure, endothelial function, C-reactive protein, inflammatory markers, prehypertension, cardiovascular health, lipid profile
- MeSH terms
- Heart Disease Risk Factors, Antihypertensive Agents, Blood Pressure, Humans, Hypertension, Periodontitis
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