gum disease, dental health

Increased Hypertension Risk in Patients With Periodontitis – Gum Disease Interview with:
Dr Eva Muñoz Aguilera BDS MFDS MClinDent (Dist) MPerio RCSEd
EFP Diploma in Periodontology and Implant Dentistry
Senior Clinical Teaching Fellow in Periodontology
UCL Eastman Dental Institute,
London What is the background for this study?

Response: High blood pressure and periodontitis are highly prevalent conditions that affect more than one third of the adult population worldwide. High blood pressure is the leading global cause of premature death and is the main preventable cause of cardiovascular disease,  while gum disease – also known as periodontitis – leads to severe inflammation of the gums and tooth loss. It impairs aesthetics and function and reduces quality of life.

Most importantly, there is increasing evidence that periodontitis increases risk for future cardiovascular disease. Both diseases share common risk factors such as obesity and smoking and are major health problems that significantly impact on health costs. What are the main findings?

Response: Our review highlighted a possible strong association between high blood pressure (hypertension) and gum disease (periodontitis). Eighty-one studies were included in the review, which were conducted in 26 different countries in all continents. We found that people who had gum disease had also a 20% greater risk of suffering from high blood pressure, and this risk increased to 50% when severe forms of gum disease were identified. Additionally, we found that patients with periodontitis had a 4.5 mmHg higher systolic and 2 mmHg higher diastolic blood pressures compared to those without. This is a significant finding as an average of 5 mmHg blood pressure rise would be linked to a 25% increased risk of death from heart attack or stroke.

Lastly, with regards to the interventional studies, just 5 out of 12 studies included in the review showed a reduction in blood pressure following gum treatment. The changes occurred even in people with healthy blood pressure levels. However, the evidence suggesting periodontal therapy could reduce blood pressure remains inconclusive. What should readers take away from your report?

Response: Oral health is closely linked to general health. Looking after oral health is often neglected and instead should be considered as important as managing other general health problems. What recommendations do you have for future research as a result of this work? 

Response: As stated in the publication, further research should focus on larger and long-term randomised controlled trials with reduction of blood pressure as primary outcome to determine the impact of periodontal therapy on blood pressure. Is there anything else you would like to add?

Response: We would like to raise awareness among all health care professionals, patients and policy makers of the association between periodontitis and hypertension. Oral health advice should be provided to all patients with hypertension and those with periodontitis should be informed of the increased risk of developing hypertension.


Eva Muñoz Aguilera, Jean Suvan, Jacopo Buti, Marta Czesnikiewicz-Guzik, Aline Barbosa Ribeiro, Marco Orlandi, Tomasz J Guzik, Aroon D Hingorani, Jose Nart, Francesco D’Aiuto. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovascular Research, 2019; DOI: 10.1093/cvr/cvz201 


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Last Modified: Sep 24, 2019 @ 8:15 pm




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