IADR Abstract Archives
Systemic Inflammation Mediates the Association Between Periodontitis and Incident Hypertension
Objectives: The aim of this five-year longitudinal study was to explore the associations between periodontitis and hypertension and the extent to which these associations were mediated through systemic inflammation.
Methods: The severity and extent of periodontitis were determined using probing depth (PD). Oral hygiene was assessed using plaque scores. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of antihypertensive medications. The associations between periodontal variables and five-year blood pressure changes or incident hypertension were analyzed using linear or Poisson regression, adjusting for age, sex, education level, body mass index, exercise frequency, smoking status, drinking status, and diabetes. Causal mediation analysis of two systemic inflammatory biomarkers, white blood cell count (WBC) and C-reactive protein (CRP) levels, was performed.
Results: The study population included 901 hypertension-free participants, aged 50-73 years. The incidence of hypertension was 289 cases (32.1%). Greater mean PD, higher % sites with PD ≥6 mm, and poor oral hygiene were associated with elevated SBP, with regression coefficients of 1.968 ± 0.783 (p = 0.012), 2.192 ± 0.757 (p = 0.004), and 0.414 ± 0.207 (p = 0.046), respectively. These periodontal variables were also associated with increased hypertension risk, with relative risks of 1.17 (95% CI: 1.02-1.34, p = 0.029), 1.13 (95% CI: 1.02-1.26, p = 0.023), and 1.08 (95% CI: 1.03-1.13, p <0.001), respectively. Periodontitis and poor oral hygiene were associated with higher WBC and CRP levels (p <0.05), which in turn were associated with increased hypertension risk (p <0.05). WBC and CRP jointly mediated 14.1-26.9% of the associations between periodontal variables and incident hypertension.
Conclusions: Our findings demonstrated that periodontitis and poor oral hygiene were associated with increased hypertension risk, and systemic inflammation was, in part, a mediator of these associations.
Methods: The severity and extent of periodontitis were determined using probing depth (PD). Oral hygiene was assessed using plaque scores. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or the use of antihypertensive medications. The associations between periodontal variables and five-year blood pressure changes or incident hypertension were analyzed using linear or Poisson regression, adjusting for age, sex, education level, body mass index, exercise frequency, smoking status, drinking status, and diabetes. Causal mediation analysis of two systemic inflammatory biomarkers, white blood cell count (WBC) and C-reactive protein (CRP) levels, was performed.
Results: The study population included 901 hypertension-free participants, aged 50-73 years. The incidence of hypertension was 289 cases (32.1%). Greater mean PD, higher % sites with PD ≥6 mm, and poor oral hygiene were associated with elevated SBP, with regression coefficients of 1.968 ± 0.783 (p = 0.012), 2.192 ± 0.757 (p = 0.004), and 0.414 ± 0.207 (p = 0.046), respectively. These periodontal variables were also associated with increased hypertension risk, with relative risks of 1.17 (95% CI: 1.02-1.34, p = 0.029), 1.13 (95% CI: 1.02-1.26, p = 0.023), and 1.08 (95% CI: 1.03-1.13, p <0.001), respectively. Periodontitis and poor oral hygiene were associated with higher WBC and CRP levels (p <0.05), which in turn were associated with increased hypertension risk (p <0.05). WBC and CRP jointly mediated 14.1-26.9% of the associations between periodontal variables and incident hypertension.
Conclusions: Our findings demonstrated that periodontitis and poor oral hygiene were associated with increased hypertension risk, and systemic inflammation was, in part, a mediator of these associations.