Is there an association between periodontitis and arterial hypertension?

Abstract

Periodontitis is estimated to affect more than 50% of the world's population and, in its severe form, it is the sixth Most common human disease. Clinical evidence supports that periodontitis affects systemic endothelial function and this may have an impact on hypertension; some reports suggest possible direct effects of microbiota-related oral bacteremia also on vascular dysfunction. The aim of this article is to understand the pathogenesis of hypertension and its association with periodontitis, as well as the possible common mechanisms involved. A review of the literature was carried out, by consulting MEDLINE, in order to analyze recent data that support that patients with periodontitis are more likely to have arterial hypertension. The conceptual framework that supports this hypothesis is discussed. The data corroborate that, in the presence of moderate periodontitis, the probability of having hypertension is 22% and this probability increases to 49% in severe forms. This condition can potentially contribute to prohypertensive immunity in several ways; in addition, it may be associated with permanent endothelial dysfunction. Thus, it became evident that inflammation and the immune system play a causal role in the pathogenesis of hypertension, although this mechanism remains unclear. From our analysis we can conclude that there is an association between periodontitis and hypertension and, therefore, periodontal therapy can be considered as a tool in the prevention and treatment of hypertension. The challenge is still open for research aimed at understanding the pathogenesis of hypertension.