Prevalence of Undiagnosed and Uncontrolled Hypertension in Thai Dental Patients

Objectives: To investigate blood pressure data from patients who received dental treatment at the Advanced General Dentistry Clinic, Faculty of Dentistry, Mahidol University, Thailand during the years 2012-2017.

Methods: Patient records were retrospectively reviewed. Factors examined included demographic data, history of diagnosed hypertension, hypertensive medication used and recorded blood pressure. Patients were categorized as having undiagnosed or diagnosed hypertension. Patients with undiagnosed hypertension were further stratified into patients with normal blood pressure, prehypertension stage, hypertension stage I and hypertension stage II according to the seventh Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure classification (JNC 7). The blood pressure was examined again according to the follow up protocol by the Thai Hypertension Society: Guidelines in the Treatment of Hypertension 2015. Patients with a history of diagnosed hypertension were diagnosed as having controlled and uncontrolled hypertension.

Results: A total of 500 charts from 326 female (65%) and 174 male patients (35%) that met specific study criteria were included. The average age of the subjects was 52 ±18 years old. One hundred and six (21%) patients had history of hypertension whereas 394 (79%) patients had no history of hypertension. After the first and the second blood pressure records were determined in 106 patients with diagnosed hypertension, 70 patients (66%) had controlled blood pressure and 36 patients (34%) had poorly controlled blood pressure. In the undiagnosed hypertensive group, 62%, 96% and 100% of patients in the prehypertension, stage I hypertension and stage II hypertension have remained in either prehypertension stage or stage I or stage II hypertension suggesting that once the patients started to have abnormal blood pressure, most of the patients either remained in the abnormal blood pressure stage or progressed to a more severe stage.

Conclusions: Our results suggested that high blood pressure was common in dental patients. If abnormal blood pressure are detected, dentists may need to encourage patients for a repeat blood pressure measurement and further medical evaluation.