Chronic Periodontitis and Hypertension:A Systematic Review

Aim: To conduct a systematic review evaluating associations between periodontal disease and hypertension.

Method: A MEDLINE literature search of papers published between 2000 and March 2016 was conducted. Cross-sectional studies, prospective studies and nested case-control studies that studied the association between periodontitis and hypertension formed the mainstay of this literature review. This systematic review was conducted on the guidelines of the Cochrane Systematic Reviews and the conclusive evidence was based on the Canadian task force on preventive health care guidelines.

Results: A total of 21 articles were searched for relevancy, determined by article title, abstract and full copy, resulting in a yield of 17 studies that met our inclusion criteria. 1) There is a fair evidence (II-2 Grade B recommendation) for an association between chronic periodontitis and blood pressure with OR of 2.93 (95% CI:1.25-6.84) but the association becomes stronger when restricted with those with hypertension or taking anti-hypertensive medications: OR = 4.20(95% CI:1.28-13.80). 2) A good evidence (I, Grade A recommendation) that intensive periodontal therapy decrease cardiovascular risk scores (Framingham) at 296 mm (1.53% F 1.20% (95% CI 1.05-2.24, P = .0290) and 2.00% F 1.42% (95% CI 0.98-4.09, P = .0568).

Conclusions: With the available literature we conclude that,

1. There is a fair evidence for an association between chronic periodontitis and hypertension.

2. Intensive periodontal therapy reduces the systemic inflammatory markers and systolic blood pressure imminently at 6 months after the end of periodontal treatment.