Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis

• Published in: Pharmacological research 2021-04, Vol.166, p.105511, Article 105511
• Main Authors: Sharma, Shiv, Sridhar, Swathi, McIntosh, Alasdair, Messow, Claudia-Martina, Aguilera, Eva Munoz, Del Pinto, Rita, Pietropaoli, Davide, Gorska, Renata, Siedlinski, Mateusz, Maffia, Pasquale, Tomaszewski, Maciej, Guzik, Tomasz J., D’Aiuto, Francesco, Czesnikiewicz-Guzik, Marta
• Format: Article
• Language: English
• Subjects: Antihypertensive Agents - therapeutic use; Blood Pressure - drug effects; CRP; Endothelial dysfunction; Heart Disease Risk Factors; Humans; Hypertension; Hypertension - etiology; Hypertension - therapy; Inflammation; LDL; Periodontitis; Periodontitis - complications; Periodontitis - therapy
• ISSN: 1043-6618; 1096-1186
• DOI: 10.1016/j.phrs.2021.105511

Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was −4.3 mmHg [95%CI: −9.10–0.48], p = 0.08 and −3.16 mmHg [95%CI: −6.51–0.19], p = 0.06 respectively. These studies were characterized by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD = −11.41 mmHg (95%CI: −13.66, −9.15) P