The association of calcium channel blockers with periodontal disease.

Objectives: Calcium channel blockers (CCBs) are widely used as anti-hypertensives and are known to cause gingival overgrowth. The objective of this study was to determine if there is an association between CCB use and periodontal disease.
Methods: Two existing datasets with periodontal phenotyping were analysed: the PRIME database from Belfast, which was collected to study risk factors for coronary heart disease, and the NHANES 2011–2012 database from the USA.
For both databases, we analysed the demographics, medical and drug history and smoking status of all those who had 6-point pocket chart measurements, which were converted into Page & Eke case definitions of periodontitis. Univariate analyses and multivariate modelling were performed for each dataset.
Results: 9.8% of 1397 PRIME subjects and 9.5% of 3313 NHANES subjects were prescribed CCBs. In the PRIME dataset, CCBs were significantly associated with moderate/severe periodontitis (p = 0.010), with 52.6% of CCB users having this level of disease compared with 41.1% of non-CCB users. Although hypertension was also associated with moderate/severe disease (p = 0.023), this was not significant when those on CCBs were excluded from the analysis.
In the NHANES dataset, CCBs were also significantly associated with moderate/severe disease (p < 0.001), with 67.9% of CCB users having this level of disease compared with 47.1% of non-CCB users. This association remained after adjusting for age, gender and smoking status.
Conclusions: These data indicate that CCB use may be an independent risk factor for developing moderate-severe periodontitis. Further research is required to investigate this preliminary finding, but an increased side effect profile of CCBs may have some influence on existing prescribing practice.