People who take medication for high blood pressure are more likely to benefit from the therapy if they have good oral health, according to a review of medical and dental exam records of more than 3,600 people with high blood pressure by the University of L’Aquila in Italy.
The review revealed that those with healthier gums had lower blood pressure and responded better to blood pressure-lowering medications compared to those who had periodontitis. Specifically, people with periodontitis were 20% less likely to reach healthy blood pressure ranges compared to patients in good oral health.
Considering these findings, the researchers said that patients with periodontal disease may warrant closer blood pressure monitoring while those diagnosed with hypertension might benefit from a referral to the dentist.
“Physicians should pay close attention to patients’ oral health, particularly those receiving treatment for hypertension, and urge those with signs of periodontal disease to seek dental care,” said lead investigator Davide Pietropaoli, DDS, PhD. “Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health.”
The target blood pressure range for people with hypertension is less than 130/80 mmHg, according to the American Heart Association (AHA)/American College of Cardiology. In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. That difference is similar to the reduction in blood pressure achieved by reducing salt intake by 6 grams, or about a teaspoon, per day.
Periodontal disease widened the gap up to 7 mmHg among people with untreated hypertension. Blood pressure medication narrowed the gap down to 3 mmHg but did not completely eliminate it, suggesting that periodontal disease may interfere with the effectiveness of blood pressure therapy.
“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 Pietropaoli.
While the study wasn’t designed to clarify exactly how periodontal disease interferes with blood pressure treatment, the researchers say their results are consistent with previous research that links low-grade inflammation with blood vessel damage and cardiovascular risk.
Hypertension is estimated to affect up to 40% of people over the age of 25 worldwide, the AHA reports. Uncontrolled or poorly controlled hypertension can lead to heart attacks, strokes, and heart failure, as well as kidney disease. Hypertension is estimated to claim 7.5 million lives worldwide, the AHA adds.
The study, “Poor Oral Health and Blood Pressure Control Among US Hypertensive Adults,” was published by Hypertension.