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Cited by 250Oral microbiology and periodontitis researchNitric Oxide and Endothelin EffectsCardiovascular Health and Disease Prevention

Periodontal infection is associated with endothelial dysfunction in healthy subjects and hypertensive patients

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Higashi, Yukihito, Goto, Chikara, Jitsuiki, Daisuke, Umemura, Takashi, Nishioka, Kenji, Hidaka, Takayuki, Takemoto, Hiroaki, Nakamura, Shuji +4 more·2008·Hypertension
DOI 10.1161/hypertensionaha.107.101535
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Abstract

The purpose of this study was to evaluate endothelial function in patients with periodontitis. We evaluated forearm blood flow responses to acetylcholine and sodium nitroprusside in patients with periodontitis who had no other cardiovascular risk factors (32 men; 25±3 years of age), in a normal control group (20 men; 26±3 years of age), and in hypertensive patients with periodontitis (28 men and 10 women; 56±12 years of age) and without periodontitis (control group; 18 men and 6 women; 54±13 years of age). Forearm blood flow was measured using strain-gauge plethysmography. Circulating levels of C-reactive protein and interleukin-6 were significantly higher in the periodontitis group than in the control group. Both in healthy and hypertensive subjects, forearm blood flow responses to acetylcholine were significantly smaller in the periodontitis group than in the control group. Sodium nitroprusside–stimulated vasodilation was similar in the 2 groups. Periodontal therapy reduced serum concentrations of C-reactive protein and interleukin-6 and augmented acetylcholine-induced vasodilation in periodontitis patients with and without hypertension. After administration of N G -monomethyl- l -arginine, an NO synthase inhibitor, forearm blood flow response to acetylcholine was similar before and after treatment. These findings suggest that periodontitis is associated with endothelial dysfunction in subjects without cardiovascular risk factors, as well as hypertensive patients, through a decrease in NO bioavailability and that systemic inflammation may be, at least in part, a cause of endothelial dysfunction, leading to cardiovascular diseases.

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  • Increases in proinflammatory cytokines, periodontal bacteria, and uncontrolled production of nitric oxide are seen in the vascular system and can lead to detrimental structural and functional changes throughout the body.

    “As a result, increases in proinflammatory cytokines (2, 6), periodontal bacteria (7), and uncontrolled production of nitric oxide (NO) (2, 8) are seen in the vascular system which can lead to detrimental structural and functional changes throughout the body.”

    From Oral inflammatory load predicts vascular function in a young adult population: a pilot study (2023) · cites this paper as [2]

    The Discussion reports that periodontitis may impair endothelial function through decreased NO production or bioavailability, and that periodontal therapy increased NO production and improved forearm vasodilation. It does not describe uncontrolled NO production or establish detrimental structural and functional changes throughout the body. (LLM, conf=0.84)

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  • Many studies have provided associations between progressed periodontal disease and vascular function, but the effect of mild gingival inflammation has been inconclusive.

    “Many studies have provided associations between progressed periodontal disease and vascular function (2, 6–8, 20, 21, 32), however the effect of mild gingival inflammation has been inconclusive (3, 13, 33, 34, 38).”

    From Oral inflammatory load predicts vascular function in a young adult population: a pilot study (2023) · cites this paper as [2]

    The Discussion reports an association between periodontitis and impaired endothelial vasodilation, supporting the general periodontal disease–vascular function link. But the Limitations identify the participants as having mild-to-moderate periodontitis, not necessarily progressed disease, and the paper does not establish that the effect of mild gingival inflammation is inconclusive. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Periodontitis is associated with the development of cardiovascular diseases such as myocardial infarction and stroke.

    “the presence of periodontitis has been shown to be associated with the development of cardiovascular diseases (CVD) such as myocardial infarction and stroke (2–5).”

    From Oral inflammatory load predicts vascular function in a young adult population: a pilot study (2023) · cites this paper as [2]

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Authors
Higashi, Y., Goto, C., Jitsuiki, D., Umemura, T., Nishioka, K., Hidaka, T., Takemoto, H., Nakamura, S., Soga, J., Chayama, K., Yoshizumi, M., & Taguchi, A.
Affiliations
Hiroshima University (JP)
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2008-02
Volume
51
Issue
2
Pages
446-453
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/hypertensionaha.107.101535
OpenAlex
W2104838871
Semantic Scholar
6f5420d53d2c84234d51e3e2fb6b9f55287e8dfb
Cited by
250
References
29
Citations by year
2026: 7 · 2025: 7 · 2024: 8 · 2023: 8 · 2022: 14 · 2021: 25 · 2020: 19 · 2019: 13 · 2018: 14 · 2017: 11 · 2016: 13 · 2015: 17 · 2014: 14 · 2013: 17 · 2012: 20
FWCI
9.76
Type
journal article
Language
en
Open access
Locations
  • Hypertension (publishedVersion)
  • PubMed (publishedVersion)
Funders
Japan Society for the Promotion of Science
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Medicine › Physiology › Nitric Oxide and Endothelin Effects
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Keywords
periodontitis, endothelial dysfunction, acetylcholine-induced vasodilation, sodium nitroprusside, forearm blood flow, C-reactive protein, interleukin-6, systemic inflammation, nitric oxide bioavailability, L-NMMA, periodontal treatment, cardiovascular risk
MeSH terms
Acetylcholine, Adult, Aged, C-Reactive Protein, Endothelium, Vascular, Enzyme Inhibitors, Female, Forearm, Humans, Hypertension, Infections, Male, Middle Aged, Nitroprusside, Osmolar Concentration, Periodontitis, Regional Blood Flow, Vasodilation, Vasodilator Agents, Interleukin-6, Nitric Oxide Synthase, omega-N-Methylarginine

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