Dental News - Poor oral health may inhibit effectiveness of hypertension medication

Dental Tribune International

Tue. 13. November 2018

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L’AQUILA, Italy: In a new study, researchers at the University of L’Aquila in Italy have highlighted the importance of oral health for patients with hypertension. Their findings show that people with high blood pressure taking medication for their condition are more likely to benefit from the therapy if their oral health is in good condition.

From their review of the medical and dental records of more than 3,600 people with high blood pressure, the researchers established that those with healthier gingivae had lower blood pressure and responded better to blood pressure-lowering medications compared with individuals who suffered from periodontitis. According to the study, people with periodontal disease were 20 per cent less likely to reach healthy blood pressure ranges than patients with good oral health were.

In another example linking oral health to general health, the researchers believe patients with periodontal disease may warrant closer blood pressure monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist.

“Patients with high blood pressure and the clinicians who care for them should be aware that good oral health may be just as important in controlling the condition as are several lifestyle interventions known to help control blood pressure, such as a low-salt diet, regular exercise and weight control,” said lead investigator Dr Davide Pietropaoli.

According to the latest recommendations from the American Heart Association and American College of Cardiology, the target blood pressure range for people with hypertension is less than 130/80 mmHg. In the study, patients with severe periodontitis had systolic pressure that was on average 3 mmHg higher than that of those with good oral health. The presence of periodontal disease widened the gap even further, up to 7 mmHg, among people with untreated hypertension, the study found. Blood pressure medication reduced the difference to 3 mmHg, but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.

Although the study did not seek to clarify how periodontal disease interferes with blood pressure treatment, Pietropaoli and his colleagues believe their results are consistent with previous research that links low-grade oral inflammation with blood vessel damage and cardiovascular risk.

The study, titled “Poor oral health and blood pressure control among US hypertensive adults”, was published in the December 2018 issue of Hypertension.

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