Association of chronic periodontitis with left ventricular mass and central blood pressure in treated patients with essential hypertension.
BACKGROUND
The aim of the study was to answer the question whether chronic periodontitis (CP) in patients with essential hypertension is associated with increased aortic stiffness and increased central blood pressure (CBP), which may in turn increase left ventricular mass (LVM) in those patients. CP influences LVM in hypertensive and renal patients as well as in healthy subjects; however, mechanisms involved are not clear.


METHODS
Fifty patients (23 men and 27 women, 51.4 +/- 5.2 years, body mass index (BMI) 29.5 +/- 4.4 kg/m(2)) with severe CP-Community Periodontal Index of Treatment Needs (CPITN) score 3-4, and 49 patients (20 men and 29 women, 49.3 +/- 5.5 years, BMI 29.9 +/- 4.8 kg/m(2)) with no or moderate CP (CPITN 0-2) were included. In all patients LVM, pulse wave velocity (PWV), and CBP were measured, and LVM index (LVMI) calculated.


RESULTS
Patients with a CPITN of 3-4 had higher LVM (257.3 +/- 67.9 vs. 220.3 +/- 66.4 g, P < 0.01), LVMI (105.8 +/- 23.6 vs. 92.6 +/- 24.8 g/m(2), P < 0.01) and higher central systolic (124 +/- 17 vs. 116 +/- 15 mm Hg, P < 0.05) and pulse pressure (45 +/- 11 vs. 38.7 +/- 9.8 mm Hg, P < 0.05) as compared with patients with a CPITN of 0-2. In the univariate analysis, for the total group a positive association was observed between CPITN values and LVM, LVMI, age, aortic systolic, and pulse pressure, but not with systemic blood pressure. Linear regression analysis showed an association of borderline significance (P = 0.06) between LVMI and the CPITN value. In other model, a significant positive relationship between CBP and CPITN was observed.


CONCLUSIONS
More severe forms of periodontitis are associated with increased CBP and LVM in patients with primary hypertension.
Franek
Edward
E
Department of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSWiA, Warsaw, Poland. Edward.Franek@cskmswia.pl
Klamczynska
Ewa
E
Ganowicz
Ewa
E
Blach
Anna
A
Budlewski
Tadeusz
T
Gorska
Renata
R
D001794:Blood Pressure; D055113:Chronic Periodontitis / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010512:Periodontal Index; D018487:Ventricular Dysfunction, Left / Q000209:etiology* / Q000473:pathology