title: Periodontal disease, hypertension, and blood pressure among older adults in Puerto Rico.
abstract: BACKGROUND
  Current scientific evidence addressing the relationship between periodontitis and hypertension is limited to studies producing inconsistent results.
  
  
  METHODS
  All participants of an ongoing representative cohort of Puerto Rican elderly who were ≥70 years old and residing in the San Juan metropolitan area were invited to this cross-sectional study. Periodontal probing depth (PD) and attachment loss (AL) were summarized using the Centers for Disease Control and Prevention and the American Academy of Periodontology definition for severe periodontitis (≥2 teeth with AL ≥6 mm and ≥1 tooth with PD ≥5 mm). Three repeated blood pressure (BP) measurements taken were averaged using a standardized auscultatory method. Information on hypertension history, use of antihypertensive medications, and potential confounders (age, sex, smoking, heavy and binge drinking, diabetes, use of preventive dental services, flossing, body mass index, consumption of fruits, vegetables, whole wheat bread, and high-fiber cereal) was collected during in-person interviews. High BP was defined as average systolic BP ≥140 mm Hg or diastolic ≥90 mm Hg. Multivariate logistic regression models were used to study the relationship between severe periodontitis, hypertension history, and high BP.
  
  
  RESULTS
  The study population comprised 182 adults. In multivariate analysis, there was no association between severe periodontitis and hypertension history (odds ratio [OR] = 0.99; 95% confidence interval [CI]: 0.40 to 2.48). Severe periodontitis was associated with high BP, with OR of 2.93 (95% CI: 1.25 to 6.84), after adjusting for age, sex, smoking, and binge drinking. This association was stronger when restricted to those with hypertension or taking antihypertensive medications: OR = 4.20 (95% CI: 1.28 to 13.80).
  
  
  CONCLUSIONS
  The results of this study suggest that periodontitis may contribute to poor BP control among older adults.
authors.affiliation: Center for Clinical Research and Health Promotion, University of Puerto Rico School of Dental Medicine, San Juan, Puerto Rico 00936-50667. sona.tumanyan@upr.edu
authors.forename: Sona
authors.initials: S
authors.lastname: Rivas-Tumanyan
authors.forename: Maribel
authors.initials: M
authors.lastname: Campos
authors.forename: Juan C
authors.initials: JC
authors.lastname: Zevallos
authors.forename: Kaumudi J
authors.initials: KJ
authors.lastname: Joshipura
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D000437:Alcoholism / Q000453:epidemiology; D016301:Alveolar Bone Loss / Q000453:epidemiology; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D001939:Bread; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D003752:Dental Health Services / Q000706:statistics & numerical data; D003920:Diabetes Mellitus / Q000453:epidemiology; D002523:Edible Grain; D005247:Feeding Behavior; D005260:Female; D005638:Fruit; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology*; D011647:Puerto Rico / Q000453:epidemiology; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data; D014675:Vegetables
chemical_list: D000959:Antihypertensive Agents