People with high blood pressure (BP) taking medication for their condition are more likely to benefit from the therapy if they have good oral health, according to a study. The research, published in the journal Hypertension, is based on a review of medical and dental exam records of more than 3,600 people with high BP.
Researchers from the University of L’Aquila in Italy found that those with healthier gums had lower BP and responded better to blood pressure-lowering medications, compared with individuals who had gum disease, a condition known as periodontitis.
People with periodontal disease were 20 per cent less likely to reach healthy BP ranges, compared with patients in good oral health, researchers said. Patients with periodontal disease may warrant closer BP monitoring, while those diagnosed with hypertension, or persistently elevated blood pressure, might benefit from a referral to a dentist, they said.
“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 Davide Pietropaoli from the University of L’Aquila. “Likewise, dental health professionals should be aware that oral health is indispensable to overall physiological health, including cardiovascular status,” Pietropaoli said.
According to the latest recommendations from the American Heart Association/American College of Cardiology, the target blood pressure range for people with hypertension is less than 130/80 millimetres of mercury (mmHg).
In the study, patients with severe periodontitis had systolic pressure that was, on average, 3 mmHg higher than those with good oral health. Systolic pressure, the upper number in a blood pressure reading, indicates the pressure of blood against the walls of the arteries.
While seemingly small, the 3mmHg difference is similar to the reduction in blood pressure that can be achieved by reducing salt intake by 6 grams per day, the researchers said. The presence of periodontal disease widened the gap even farther, up to 7 mmHg, among people with untreated hypertension, the study found. 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,” Pietropaoli said.