title: Additive interaction of oral health disorders on risk of hypertension in a Japanese urban population: the Suita Study.
abstract: BACKGROUND
  This study assessed the relationship between different oral health markers-periodontitis, gingival bleeding, tooth number, and occlusal status-and hypertension in a Japanese urban population.
  
  
  METHODS
  A total of 1,643 participants with no prior cardiovascular disease (mean age = 66.6 years; 43.4% women) underwent comprehensive health checkups, including a lifestyle questionnaire and dental examination in the Suita Study.
  
  
  RESULTS
  In the multivariable-adjusted logistic model, none of the individual oral health markers, namely severe periodontitis, gingival bleeding, lowest quartile of tooth number, and malocclusion, were significantly associated with increased odds of hypertension. The additive effects of oral health markers on hypertension were examined and showed that, compared with subjects with no component of the oral health markers, the multivariale-adjusted odds ratio of hypertension in those with ≥3 components was 1.82 (95% confidence interval (CI) = 1.23-2.72; P = 0.003). In the subpopulation without antihypertensive medication (n = 1,148; 59.8% women), a significant graded relationship between multivariable-adjusted systolic blood pressure and the number of components was found (P trend = 0.03), and, compared with subjects with no component of the oral health markers, having ≥3 components was related to a higher systolic blood pressure (β = 5.41; 95% CI = 1.16-9.66; P = 0.01).
  
  
  CONCLUSIONS
  There is an additive relationship between oral health disorders and risk of hypertension. Our results suggest that the existence of moderate or severe oral health disorders-that is, several concomitant oral health disorders-is associated with risk of hypertension.
authors.affiliation: Divisions of Hypertension and Nephrology, and.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Iwashima
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.forename: Takahiro
authors.initials: T
authors.lastname: Ono
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yoshimuta
authors.forename: Momoyo
authors.initials: M
authors.lastname: Kida
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kosaka
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maeda
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D016009:Chi-Square Distribution; D003766:Dental Occlusion; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008310:Malocclusion / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009909:Oral Health; D010512:Periodontal Index; D010518:Periodontitis / Q000175:diagnosis / Q000453:epidemiology*; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014076:Tooth Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016388:Tooth Loss / Q000453:epidemiology; D014504:Urban Health
keywords: blood pressure; hypertension; life style; oral health disorder; risk factor.