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By Will Boggs MD
(Reuters Health) – Hypertension patients find it harder to manage their blood pressure than their oral health problems, according to a new study.
Among people treated for hypertension (high blood pressure), people with gingivitis had average blood pressure readings of 2 to 3 mmHg (milligrams of mercury) greater than those without gum disease and were less likely to control their pressure with drugs.
"Recent literature suggests that poor oral health is associated with several widespread conditions, such as cardiovascular disease, diabetes, stroke and obesity, and that it is linked to increased mortality, "said Dr. Davide Pietropaoli of the San Salvatore Hospital of the University of L'Aquila, Italy, told Reuters Health.
"However, what we did not know and we surprised, is that a disorder called periodontal disease can affect the effectiveness of drugs for hypertension."
Researchers analyzed data from the US annual health and nutrition survey conducted between 2009 and 2014 on adults over 30 years of age with high blood pressure who had a dental examination, of which 3,626 who reported taking drugs to control their high blood pressure and 460 were not.
According to the dental examinations, about 52% of the participants had periodontal disease, a chronic inflammation of the tissues around the roots of the teeth, which was also associated with greater inflammation throughout the body, noted the researchers in the Hypertension journal. Most people with gum disease had moderately severe cases, about 3% had mild illness and 12% had serious gum disease.
The researchers found that the average systolic blood pressure – the pressure exerted on the walls of blood vessels when the heart is pumping, and usually the first digit indicated in the reading of blood pressure – has gradually increased from mild to moderate periodontal disease. to severe.
Overall, people with hypertension and periodontal disease were 20% more likely than those without gum disease to not control their hypertension with medication.
In addition, blood pressure control was worse in patients with periodontal disease in all age groups.
Among hypertensive patients not taking medication for hypertension, systolic blood pressure was on average 2.8 to 7.6 mmHg higher in the presence of periodontitis, although periodontitis does not appear to increase their risk of developing hypertension. Have a blood pressure higher than 130/80 mmHg (treatment threshold).
The study was not a controlled experiment designed to prove whether or how gum disease or inflammation that it creates could directly affect blood pressure.
"If our results are confirmed by specific tests, oral health could improve the treatment of hypertension, which is considered to be the most important risk factor for cardiovascular disease," Pietropaoli said in a letter. electronic. "Patients with treated high blood pressure can benefit from a program dedicated to reducing oral periodontal inflammation by calling in a dentist or periodontist."
The researchers also suggest that periodontal therapy, combined with lifestyle measures (exercise, healthy eating, etc.), could help lower blood pressure and possibly limit the need for drugs for hypertension.
SOURCE: https://bit.ly/2z2tLrA Hypertension, online 22 October 2018.
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