Relationship Between Periodontitis and Hypertension Among Older Adults

Background: A number of studies have shown significant associations between periodontal disease and cardiovascular endpoints. However, only a few studies assessed the relationship between periodontal disease and hypertension.

Objective: To evaluate whether periodontal disease is related with hypertension and blood pressure (BP).

Methods: 183 adults (70 years and older) residing in San Juan metropolitan area were recruited in this cross-sectional study from an on-going representative cohort. Periodontal disease was assessed by clinical measurements of probing depth (PD) and attachment loss (AL) at 4 sites per tooth using a full-mouth design (excluding third molars). We used CDC-AAP definition for severe periodontitis (³2 teeth with AL ³ 6mm and ³1 tooth with PD ³ 5 mm). Data on hypertension diagnosis and confounders was collected during in-person interview. Hypertension was defined as self-reported physician diagnosis. Standardized indirect blood pressure determination by auscultatory method was used, and three repeated measurements were averaged. BP was classified as high if average systolic BP was ³ 140 mm or average diastolic BP was ³ 90 mm. Multivariate logistic regression models were used, adjusting for age, gender, smoking (current, past, never), heavy and binge drinking, diabetes, utilization of preventive dental services, being overweight (BMI ³25), tertiles of fruit and vegetable, whole wheat bread and high-fiber cereal consumption. Odds ratios and 95% CI were calculated.

Results: After controlling for confounders, severe periodontitis was not associated with hypertension (OR=0.98). However, severe periodontitis was related with nearly four-fold higher odds of high blood pressure (OR=3.93; 95%CI: 1.46, 10.58; additionally adjusting for hypertension). This association was stronger when restricted to those with hypertension diagnosis or taking anti-hypertensive medications: OR = 7.02 (95%CI: 1.63; 30.16).

Conclusions: We found a strong association between severe periodontitis and high blood pressure among people 70 and older.

The study was supported by NIH Grants R01AG1620904, G12RR03051, K24DE16884.