Periodontitis and Hypertension: Is the Association Causal?

High blood pressure (BP) and periodontitis are two highly prevalent conditions worldwide with a significant impact on cardiovascular disease (CVD) complications. Poor periodontal health is associated with increased prevalence of hypertension and may have an influence on BP control. Risk factors such...

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Bibliographic Details
Published in:High blood pressure & cardiovascular prevention 2020-08, Vol.27 (4), p.281-289
Main Authors: Del Pinto, Rita, Pietropaoli, Davide, Munoz-Aguilera, Eva, D’Aiuto, Francesco, Czesnikiewicz-Guzik, Marta, Monaco, Annalisa, Guzik, Tomasz J., Ferri, Claudio
Format: Article
Language:English
Subjects:
Age
Body mass index
Cardiology
Cardiovascular disease
Creatinine
Diabetes
Ethnicity
Gender
Gum disease
Heart
Hypertension
Inflammation
Medicine
Medicine & Public Health
Obesity
Older people
Oral hygiene
Pharmacotherapy
Pilot projects
Review Article
Risk factors
Socioeconomic factors
Socioeconomic status
Systematic review
Tumor necrosis factor-TNF
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Summary:High blood pressure (BP) and periodontitis are two highly prevalent conditions worldwide with a significant impact on cardiovascular disease (CVD) complications. Poor periodontal health is associated with increased prevalence of hypertension and may have an influence on BP control. Risk factors such as older age, male gender, non-Caucasian ethnicity, smoking, overweight/obesity, diabetes, low socioeconomic status, and poor education have been considered the common denominators underpinning this relationship. However, recent evidence indicates that the association between periodontitis and hypertension is independent of common risk factors and may in fact be causal in nature. Low-grade systemic inflammation and redox imbalance, in particular, represent the major underlying mechanisms in this relationship. Neutrophil dysfunction, imbalance in T cell subtypes, oral-gut dysbiosis, hyperexpression of proinflammatory genes, and increased sympathetic outflow are some of the pathogenetic events involved. In addition, novel findings indicate that common genetic bases might shape the immune profile towards this clinical phenotype, offering a rationale for potential therapeutic and prevention strategies of public health interest. This review summarizes recent advances, knowledge gaps and possible future directions in the field.
ISSN:1120-9879
1179-1985
DOI:10.1007/s40292-020-00392-z