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Do you strive to control your high blood pressure even with the help of medication?
Open your mouth and say "aha!" if you see cavities or sore gums, bleeding or receding. You may have found the culprit.
The researchers reported Monday that, in adults whose hypertension was treated with medication, systolic blood pressure, which measures the pressure in the vessels when the heart beats, increases as the health of their teeth and their gums are degraded.
Compared with hypertensive patients who showed no evidence of periodontal disease, those with inflamed gums were 20% less likely to have their blood pressure within healthy limits. In addition, the systolic blood pressure of patients with poor dental health was 3 mm HG higher on average than similar patients with healthy gums.
The results were published in the journal Hypertension.
It is estimated that one in three Americans, or 75 million Americans, suffer from high blood pressure, which exposes it to an increased risk of heart attack and stroke. . Hypertension is a leading or leading cause of more than 1,000 deaths a day in the United States. Yet only 54% of people with the disease have mastered their blood pressure measurements by combining drugs, diet and exercise.
The new study is consistent with a mountain of research linking gum disease to higher rates of heart disease, blood vessels and kidneys – all organs affected by high blood pressure. And he breaks new ground by detailing how poor dental health thwarts efforts to control hypertension.
In fact, the study found that the blood pressure of people with untreated high blood pressure and healthy gums was about the same as those who took medication to treat their high blood pressure, but who also had an illness. gums.
In other words, poor dental health has largely negated the effects of taking medication for hypertension.
New research does not establish that gum disease is the cause of hypertension and its adverse health effects. Many researchers suspect that, like stiff blood vessels, painful and bleeding gums are only one manifestation of more inflammation throughout the body.
The study also does not show that the treatment of periodontitis will reduce high blood pressure.
But this suggests that when dental health is bad, the challenge of controlling blood pressure will be more expensive and will be more likely to fail.
Italian researchers examined 11,753 Americans who participated in the national health and nutrition survey between 2009 and 201 4 and were screened for periodontal disease. Some 4095 participants had been diagnosed with hypertension, of whom 88.5% were taking medication for treatment and 11.5% were not doing so.
Rates of moderate and severe periodontal disease tended to be higher among study participants, men, the elderly, Latino, smokers and those with lower incomes and education. Participants aged 65 years or older and with long-term signs of periodontal disease were significantly more likely than those with less severe and long-standing gum disease to have uncontrolled hypertension – a a trend that was particularly evident among Latinos.
Hypertension and periodontitis are more common among African Americans and Latinos in the United States. These patient populations also have remarkably higher rates of diseases related to both diseases, including heart disease, kidney failure and cerebrovascular diseases such as stroke and some forms of dementia.
Some evidence suggests that African Americans might be genetically vulnerable to high blood pressure, but this remains controversial. There is little doubt that access to health care varies according to race and ethnicity, and that barriers to good medical and dental care play a key role in health disparities. racial and ethnic groups.
Dental care, in particular, is expensive and far less likely than medical care to be fully covered by insurance. As a result, economic factors probably play an important role in the patient's gum health.
In addition, many primary care physicians and cardiologists do not ask their patients questions about their dental health or refer them to a dentist unless they have cardiac surgery and obvious signs of tooth decay. And dentists do not necessarily check the blood pressure of their patients.
The study authors wrote that the health of their gums should be taken into account in hypertensive patients when they are considering treatment options.
"Our data suggest that all racial / ethnic subgroups, especially Hispanics, could benefit from such an approach," they wrote. "Conversely, ignoring the additional burden of poor periodontal status on blood pressure could result in a higher cardiovascular risk in the long term."
Charlene Niemi, Director of Health Literacy for Care Harbor, a California-based nonprofit charity that provides free medical, dental and eye care in large "ephemeral" health care clinics across the state said it was "imperative that people's care and treatment of gum disease play a role in blood pressure."
Although everyone needs regular visits to the dentist, "people with hypertension need to understand the importance of having a dental hospital, seek routine follow-up and practice care oral quality, "Niemi said. Linking underserved patients to such routine care is a core mission of Care Harbor.
At a time when federal health insurance for the poor and the disabled is reduced and the requirements of the Affordable Care Act are being negated, it is unlikely that patients with gum disease will have better access to health care. dental care in the near future.
But if they did, it could help, said Dr. Gregg L. Fonarow, a cardiologist at UCLA.
"That's what this data suggests, but it should be proven," Fonarow said.
In the meantime, he said, the existence of a link is clear: hypertensive patients must make every effort to improve their oral health and those whose l? Or. Gum condition is mediocre need to be vigilant.
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