title: Effect of antihypertensive therapy with angiotensin-converting enzyme inhibitors on chronic periodontitis: a case-control study.
abstract: BACKGROUND
  Angiotensin-converting enzyme (ACE) downregulates the activity of bradykinin, a potent proinflammatory and immunostimulatory peptide liberated from an internal portion of kininogens. Here, we asked whether periodontitis is worsened in patients under antihypertensive treatment with ACE inhibitors.
  
  
  METHODS
  Periodontal parameters were recorded from 30 individuals taking ACE inhibitors (case) and 35 taking a non-ACE inhibitor medication (control). Data were analyzed by nonparametric and parametric statistical tests.
  
  
  RESULTS
  Most sociodemographic figures were similar in both groups. However, family income was statistically higher in the control group, and the percentage of sites with visible plaque (PL) was statistically higher in the case group (P = 0.043 and P = 0.005, respectively). The prevalence of individuals with chronic periodontitis varied from 31.5% in the control group to 63.4% in the case group (P = 0.001). Patients in the case group presented a 3.2-fold higher risk of having sites with pocket depth ≥5 mm and a 2.9-fold higher risk of having sites with clinical attachment loss ≥5 mm in comparison with those in the control group (P = 0.009 and P = 0.001, respectively; adjusted for family income and visible PL).
  
  
  CONCLUSIONS
  Angiotensin-converting enzyme inhibitors may increase the prevalence and extent of chronic periodontitis in Brazilian patients.
authors.affiliation: Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Rodrigues
authors.affiliation: Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: D
authors.initials: D
authors.lastname: Barbirato
authors.affiliation: Institute for Collective Health Studies, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: R R
authors.initials: RR
authors.lastname: Luiz
authors.affiliation: Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: J
authors.initials: J
authors.lastname: Scharfstein
authors.affiliation: School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: G F
authors.initials: GF
authors.lastname: Salles
authors.affiliation: Division of Graduate Periodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. eduferes@yahoo.com.br.
authors.forename: E J
authors.initials: EJ
authors.lastname: Feres-Filho
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D005888:Gingival Pocket / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents
keywords: angiotensin-converting enzyme inhibitors; antihypertensive agents; bradykinin; chronic periodontitis; prevalence; risk