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Periodontitis increases the risk of high blood pressure.

 People with periodontitis register up to 60% more risk of having high blood pressure.

Periodontitis increases the risk of high blood pressure

A recent study published in the Journal of Internal Medicine suggests that systemic inflammation may be the determining factor linking periodontal disease and high blood pressure.  

The results of a previous study by the same group confirmed the relationship between periodontitis and hypertension; however, the mechanisms that support the association between these two diseases had not been previously investigated. It has now been confirmed that periodontitis is closely linked to hypertension and systemic inflammation is essentially a mediator of this association. 

The key: systemic inflammation

This is one of the main conclusions shown in the study "Is Systemic Inflammation a Missing Link Between Periodontitis and Hypertension? Results from Two Large Population-based Surveys". 
The study confirms that the link between periodontitis and hypertension is mediated by systemic inflammation.
This cross-sectional study was designed to investigate the relationship between periodontitis and hypertension and, in turn, to analyze the role of systemic inflammation as a mediator of this association. For this purpose, the researchers carried out the analysis of international databases (NHANES and KNHANES) with representative samples of the populations of the United States and North Korea. In addition, linear regression models, logistics, and mediation analyses were carried out.

Main findings

The study's results corroborated that participants with periodontitis had a 60% higher risk of hypertension than those with healthy gums; these associations were independent of age, sex, smoking level, and alcohol consumption, among other variables. These results are consistent with previous studies and with literature reviews and meta-analyses on the association between periodontitis and hypertension. 

Treatment of periodontitis may represent a novel non-pharmacological treatment to help control high blood pressure and reduce its complications 

In addition, it has been highlighted that markers of systemic inflammation, such as C-reactive protein and leukocyte count, were elevated in patients with periodontitis and acted as mediators of this relationship.

Therefore, this study suggests that systemic inflammation caused by periodontitis may lead to increased blood pressure. If this association is proven causal, treatment of periodontitis would improve oral health and represent a novel non-pharmacologic treatment to help control high blood pressure and reduce its complications. 

Next steps

To date, scientific evidence linking hypertension and periodontitis is based primarily on epidemiological studies. However, there are very few clinical trials with a robust design that have proven that adequate periodontal treatment leads to a reduction in blood pressure. Therefore, a multi-center clinical trial is currently being designed to evaluate the effects of periodontal therapy on hypertension and, in turn, to obtain a more detailed understanding of the molecular mechanisms through which periodontitis promotes the development of hypertension. 

Current scientific evidence suggests that low-grade systemic inflammation promotes endothelial dysfunction and oxidative stress, mechanisms involved in the development of hypertension. Periodontal disease, in turn, is related to elevated markers of systemic inflammation. Therefore, from a biological point of view, it is plausible that these two diseases are linked, and the elevation of systemic inflammation markers could play a vital role.