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Is periodontal inflammation associated with raised blood pressure? Evidence from a National US survey
Abstract
There is incomplete and inconclusive evidence for the association between periodontal disease markers and arterial blood pressure, particularly from large national epidemiological studies. This study assessed the relationship between different markers of periodontal inflammation and disease with arterial blood pressure in people aged 17 years and over in USA. We analysed data from the Third National Health and Nutrition Examination Survey on 6617 men and 7377 women who received a periodontal examination. Blood pressure was analysed in both a continuous format and a binary variable for case definition of hypertension. Periodontal disease markers (extent of gingival bleeding, pocket depth, and loss of attachment, and a case definition of periodontitis) were associated on the arterial blood pressure outcomes through a series of regression models, incrementally adjusting for confounders (demographic, inflammation markers, chronic conditions, smoking, BMI, socio-economic status). All periodontal measures had significant crude associations with SBP and hypertension. Gingival bleeding, a marker of current periodontal inflammation, was the only measure consistently and significantly associated with raised SBP and an increased odds of hypertension in the US adult population throughout the adjustment process. For a 10% greater extent of gingival bleeding, the average SBP was higher by 0.5 (0.3, 0.6) mmHg in the fully adjusted model. By referring to the general population and the whole distribution of blood pressure, not only to those at higher risk for hypertension, this association might have some important implications for clinical practice and public health strategies.
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“Several studies appear to support a relationship between severe periodontitis and hypertension.[24][25][26][27]”
From Periodontitis is associated with hypertension: a systematic review and meta-analysis (2020) · cites this paper as [24]
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Abreu, L. M. G., Lopes, F. F., Pereira, A. D. F. V., Pereira, A. L. A., & Alves, C. M. C. (2012) · RSBO Revista Sul-Brasileira de Odontologia · Cited by 5
Periodontal conditions of essential hypertension attendees to a general hospital in Hong Kong
Chiu, J., Zheng, Y., Lai, S., Chan, W., Yeung, S., Bow, H., Samartzis, D., Corbet, E., & Leung, W. K. (2020) · Australian Dental Journal · doi:10.1111/adj.12784 · Cited by 6
Davidopoulou, S., Pikilidou, M. I., Yavropoulou, M. P., Kalogirou, T. E., Zebekakis, P. E., & Kalfas, S. (2021) · The Journal of Contemporary Dental Practice · doi:10.5005/jp-journals-10024-3189 · Cited by 5
Periodontal disease and hypertension: the pre-eclampsia model in Hispanic population
López-Jaramillo, P. A., Gómez-Arbeláez, D., & López-López, J. (2011) · Journal of Hypertension · doi:10.1097/hjh.0b013e328344b6e8 · Cited by 5
Examination of the Relation Between Periodontal Disease Indices in Patients with Systemic Diseases
Chrysanthakopoulos, N. A., & Chrysanthakopoulos, P. A. (2013) · Acta Stomatologica Croatica · doi:10.15644/asc47/3/3 · Cited by 4
Impact of Periodontitis on Cardiovascular Diseases
Agarwal, S. K. (2021) · European Journal of Dental and Oral Health · doi:10.24018/ejdent.2021.2.2.48 · Cited by 5
Association between periodontal condition and blood pressure is confounded by smoking
Ollikainen, E., Saxlin, T., Tervonen, T., Suominen, A. L., Knuuttila, M. L. E., Jula, A., & Ylöstalo, P. (2022) · Acta Odontologica Scandinavica · doi:10.1080/00016357.2022.2035430 · Cited by 4
Corraini, P., López, R., & Væth, M. (2015) · Community Dentistry And Oral Epidemiology · doi:10.1111/cdoe.12142 · Cited by 4
Interdisciplinary Care Model: Chronic Kidney Disease and Oral Health
Glurich, I., Shimpi, N. A., & Acharya, A. (2018) · Health informatics · doi:10.1007/978-3-319-98298-4_7 · Cited by 3
Systemic Factors Affecting Prognosis and Outcomes in Periodontal Disease
Sangalli, L., Banday, F., Sullivan, A., & Anjum, K. (2024) · Dental Clinics of North America · doi:10.1016/j.cden.2024.05.001 · Cited by 3
Stress, Inflammation, and Coronary Heart Disease
Steptoe, A. (2011) · Springer eBooks · doi:10.1007/978-1-84882-419-5_7 · Cited by 3
Hypertension and periodontal status in Senegalese patients: A case-control study
Leye, M. M. C. B. O., Diouf, M., Madozein, W. S. T., Jobe, M., Sarr, E. H. M., Manga, S. J., Diallo, A. D., & Diop, I. B. (2014) · Open Journal of Epidemiology · doi:10.4236/ojepi.2014.41005 · Cited by 3
Systemic Manifestations of Periodontal Disease
Stepaniuk, K. S., & Hinrichs, J. E. (2012) · Wiley eBooks · doi:10.1002/9781118705018.ch7 · Cited by 3
Metadata
- Authors
- Tsakos, G., Sabbah, W., Hingorani, A. D., Netuveli, G., Donos, N., Watt, R. G., & D'Aiuto, F.
- Affiliations
- University College London (GB)
- Imperial College London (GB)
- Corresponding author
- Tsakos, Georgios
- Venue
- Journal of Hypertension
- Published
- 2010-12
- Volume
- 28
- Issue
- 12
- Pages
- 2386-2393
- ISSN
- 0263-6352 (ISSN-L)
- OpenAlex
- W1977223297
- Cited by
- 134
- References
- 52
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 8 · 2023: 7 · 2022: 15 · 2021: 15 · 2020: 16 · 2019: 8 · 2018: 7 · 2017: 5 · 2016: 8 · 2015: 10 · 2014: 7 · 2013: 9 · 2012: 4
- FWCI
- 8.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- 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 › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- periodontal inflammation, periodontal disease, hypertension, arterial blood pressure, gingival bleeding, periodontitis, probing depth, attachment loss, systolic blood pressure, NHANES
- MeSH terms
- Blood Pressure, Female, Health Surveys, Humans, Hypertension, Male, Periodontitis, Risk Factors, United States
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