The Dentist's Contribution to Diagnosis of Hypertension and Arterial Stiffness

Objectives: Determination of Arterial Pressure (AP) in the dental office contributes to identifying patients (P) at risk of cardiovascular events. Objectives: To estimate hypertension (HTN) prevalence in the dental office and compare arterial stiffness parameters (ASP) of P with and without HTN.
Methods: A prospective comparative prevalence study was conducted. All P signed an informed consent form. Corah’s Modified Dental Anxiety Scale and a pain scale were administered; P with severe anxiety and/or a pain score >5 were excluded. History of HTN and Atherogenic Risk Factors (ARF) were assessed. Prior to treatment, the dentist checked the P’s AP twice. Diagnosis of HTN (AP ≥140/90 mmHg) was confirmed by cardiologists. ARF, i.e. β stiffness index, elastic modulus, and compliance, were assessed in HTN patients using carotid ultrasound, and were compared to non-hypertensive P. Statistics: SPSS 20, ANOVA, t Test, α<0.05 and 95%CI.
Results: The study comprised 844 P, aged 41.12±12.50 years; 434 (51.42%) were women. ARF: HTN 16.46%, diabetes 3.6%, hypercholesterolemia 3.4%, smoking 16.6%, and obesity 15.3%. No differences were found between baseline and post-treatment AP values. HTN was detected in 129 (15.28%) P: 70 (54.26%) P with unknown hypertension and 59 (45.73%) P with known hypertension. Comparison of ASP of control patients (n=50) and P with known inadequately controlled, or unknown HTN showed: β index: 3.68±0.73 vs. 4.20±0.92 [p=0.0005; 95%CI -1.46 – (-0.53)] and [4.03±0.18 p=0.001 95%CI -1.12 – (-0.78)], elastic modulus (Ep;KPa) 38.64±8.13 vs. 47.24±16 [p=0.002 95%CI -14.91 – (-3.08)] and 43.12±10 [p=0.01 95%CI -7.93 – (-11.32)] and compliance (mm²/KPa) 1.52±0.31 vs. 1.30±0.33 [p=0.001 95%CI 1.23-0.87] vs. 1.46±0.44 [p=0.001; 95%CI 1.27 - 0.93]. No differences were observed in the remaining ARF.
Conclusions: HTN prevalence was 15.28%, with unknown HTN accounting for 8.29% and inadequately controlled HTN for 7%. These patients diagnosed at the dental office showed worse ARP values than controls.