The Correlation Between Periodontal Disease And Hypertension

Objective:Published evidence showed that periodontal disease is associated with hypertension.However,such results remains controversial and lacks evidence in Chinese population.Therefore,the aim of this study was to investigate the association between periodontal disease and hypertension in Chinese population.Methods:Two studies were used in this study.First,A cross-sectional study was used to analyze the available physical examination data of the faculty collected by the Henan university in 2017,A total of 4930 participants from an available health examination that were selected for this retrospective study.The correlations between periodontal disease(gingivitis and periodontitis)and hypertension were investigated using univariate and multiple logistic regression analyses and propensity score adjusted analysis.Interaction and subgroup analyses were also used to detect in variable factors.Second,Meta-analysis was used to search PubMed,EMbase,The Cochrane Library,CBM,CNKI,WangFang and VIP databases to search for the correlation between periodontal disease and hypertension.The search time was from the establishment of the library to January 2019.All studies were screened,extracted and reviewed according to NOS tool by 2 researchers,and then given a Meta-analysis by using CMA v2.0 software.Results:The cross-sectional study was carried out in strict accordance with the inclusion and exclusion criteria and was eventually included in 3952 participants.The normal blood pressure group was 2761(69.86%),the hypertension group was 1191(30.14%),and the periodontal disease was 1388(35.12%),including gingivitis 985(24.92%)and periodontitis 403(10.20%).The mean age of the normal blood pressure group was 43.00 years(36.00-56.00),and the hypertension group was 57.00 years(46.00-68.00).In the normal blood pressure group,1363(49.37%)males and 1398(50.63%)females,the male to female ratio was close to 1:1,the hypertension group was 834(70.03%),the female 357(29.97%),and the male to female ratio was 2.3:1;the normal blood pressure group periodontitis and gingivitis accounted for 239(8.66%)and 684(24.77%),respectively;hypertensive group had periodontitis 164(13.77%)and gingivitis 301(25.27%).Statistical analysis showed that exposure to periodontal disease increased the incidence of hypertension by 1.28 times(OR = 1.28,95% CI = 1.14-1.47)before periodontal disease and hypertension correction;periodontal disease increased risk of hypertension by 1.34 times(OR = 1.34,95% CI = 1.14-1.58).The results of the propensity score were also statistically different,and periodontal disease increased the risk of hypertension by 1.23 times(OR = 1.23,95% CI = 1.06-1.42).Meta-analysis showed that 24 studies were included,including 4 Chinese articles,20 English articles,2 cohort studies,5 case-control studies and 17 cross-sectional studies.The overall results of the meta-analysis showed a 1.75-fold(OR=1.75,95% CI= 1.37-2.24)increased risk of hypertension in people exposed to periodontal disease.Subgroup analyses were performed based on study type,risk factor correction,data source,and ethnicity.In cross-sectional studies,periodontal disease in European and Asian populations increased the prevalence of hypertension by 1.66 times(OR=1.66,95% CI= 1.25-2.19),1.54 times(OR=1.54,95% CI= 1.13-2.09)and 1.93 times(OR=1.93,95% CI= 1.51-2.47).In addition,periodontal disease increased the risk of hypertension by 2.26 times(OR=2.26,95% CI= 1.29-3.96)before adjusting for risk factors.After adjusting for risk factors,periodontal disease can still increase the risk of hypertension by 1.57 times(OR=1.57,95%CI= 1.30-1.89),Comparing the data from the periodontal disease in the hospital population(OR=1.95,95% CI= 1.43-2.67)with the census population(OR=1.54,95% CI= 1.17-2.03),which showed the prevalence of hypertension is high in the hospital population.The funnel plot suggested that there was a publication bias,and the sensitivity analysis showed no significant change,indicating that the meta-analysis results were robust.Conclusions:Cross-sectional studies suggest that a positive correlation between periodontal disease and risk of hypertension,and meta-analysis also shows an increased risk of hypertension in people exposed to periodontal disease 1.75 times,and inflammatory factors might underlie hypertension.