title: Is there a connection between sublingual varices and hypertension?
abstract: BACKGROUND
  Sublingual varices have earlier been related to ageing, smoking and cardiovascular disease. The aim of this study was to investigate whether sublingual varices are related to presence of hypertension.
  
  
  METHODS
  In an observational clinical study among 431 dental patients tongue status and blood pressure were documented. Digital photographs of the lateral borders of the tongue for grading of sublingual varices were taken, and blood pressure was measured. Those patients without previous diagnosis of hypertension and with a noted blood pressure ≥ 140 mmHg and/or ≥ 90 mmHg at the dental clinic performed complementary home blood pressure during one week. Those with an average home blood pressure ≥ 135 mmHg and/or ≥ 85 mmHg were referred to the primary health care centre, where three office blood pressure measurements were taken with one week intervals. Two independent blinded observers studied the photographs of the tongues. Each photograph was graded as none/few (grade 0) or medium/severe (grade 1) presence of sublingual varices. Pearson's Chi-square test, Student's t-test, and multiple regression analysis were applied. Power calculation stipulated a study population of 323 patients.
  
  
  RESULTS
  An association between sublingual varices and hypertension was found (OR = 2.25, p < 0.002). Mean systolic blood pressure was 123 and 132 mmHg in patients with grade 0 and grade 1 sublingual varices, respectively (p < 0.0001, CI 95 %). Mean diastolic blood pressure was 80 and 83 mmHg in patients with grade 0 and grade 1 sublingual varices, respectively (p < 0.005, CI 95 %). Sublingual varices indicate hypertension with a positive predictive value of 0.5 and a negative predictive value of 0.80.
  
  
  CONCLUSIONS
  An association was found between sublingual varices and hypertension. Examining the lateral borders of the tongue is easily done, causes no harm and could be a valuable method for the dental profession to take active part in preventive healthcare.
authors.affiliation: Public Dental Services, Box 1254, S-43218, Varberg, Sweden. lennart.hedstrom@regionhalland.se.
authors.forename: Lennart
authors.initials: L
authors.lastname: Hedström
authors.affiliation: Public Dental Services, Box 1254, S-43218, Varberg, Sweden. margit.albrektsson@regionhalland.se.
authors.forename: Margit
authors.initials: M
authors.lastname: Albrektsson
authors.affiliation: Research & Development Unit, County of Halland, 30185, Halmstad, Sweden. hakan.bergh@regionhalland.se.
authors.forename: Håkan
authors.initials: H
authors.lastname: Bergh
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications; D001281:Atrial Fibrillation / Q000150:complications; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D017202:Myocardial Ischemia / Q000150:complications; D010781:Photography / Q000379:methods; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012907:Smoking; D020521:Stroke / Q000150:complications; D014059:Tongue / Q000098:blood supply*; D014648:Varicose Veins / Q000150:complications*