LONDON — What do puffy, bleeding gums have to do with high blood pressure? Apparently more than you might expect. New research has found that people battling gum disease are more likely to suffer from hypertension.
High blood pressure is the leading cause of premature deaths worldwide, impacting 30% to 45% of the population. Similarly, inflammation of the gums, connective tissue and bones supporting the teeth (periodontitis) is present in more than half of the world’s population. Doctors say it’s no coincidence so many people struggle with both conditions.
“Hypertension could be the driver of heart attack and stroke in patients with periodontitis,” observes lead study author Francesco D’Aiuto, a professor at the Eastman Dental Institute of University College London, in a statement.
Past research has suggested a link between the two ailments. For the current study, researchers gathered information from 81 studies conducted in 26 countries. They sought to determine how often patients with moderate to severe cases of gum disease also have high blood pressure. Results showed that patients with periodontitis tended to have higher arterial blood pressure — 4.5 mmHg higher systolic (contracted) and 2 mmHg higher diastolic (resting) blood pressures, on average.
While this may seem like a small number, researchers say that just a 5 mmHg rise in blood pressure increases the risk of death from heart attack or stroke by 25%. In all, the authors calculated that the odds of having hypertension were 22% higher for patients with moderate to severe periodontitis and 49% higher for patients with severe periodontitis.
“We observed a linear association–the more severe periodontitis is, the higher the probability of hypertension,” says D’Aiuto.
As for a possible explanation for the finding, the authors say that oral bacteria which goes along with periodontitis leads to inflammation throughout the body, including the blood vessels. Other related factors may play a part, including genetics and such risk factors as smoking and obesity.
“In many countries throughout the world, oral health is not checked regularly, and gum disease remains untreated for many years,” observes D’Aiuto. “The hypothesis is that this situation of oral and systemic inflammation and response to bacteria accumulates on top of existing risk factors.”
Whatever the cause of periodontitis, researchers say those with gum disease should be told about their risk for high blood pressure and given advice on diet and exercise. They caution that the jury is still out regarding the relationship between periodontal treatments and lowered blood pressure. They believe randomized trials are the next step needed to prove the benefits of periodontal therapy.
While this study looked at gum disease as a possible risk factor for hypertension, researchers point out that the opposite could also be true. “Further research is needed to examine whether patients with high blood pressure have a raised likelihood of gum disease. It seems prudent to provide oral health advice to those with hypertension,” D’Aiuto concludes.
Study results are published in Cardiovascular Research, a journal of the European Society of Cardiology (ESC).