title: Effect of angiotensin-converting enzyme inhibitors on vascular endothelial function in hypertensive patients after intensive periodontal treatment.
abstract: There is a relation between vascular endothelial function, atherosclerotic disease, and inflammation. Deterioration of endothelial function has been observed twenty-four hours after intensive periodontal treatment. This effect may be counteracted by the action of angiotensin-converting enzyme inhibitors, which improve endothelial function. The aim of the present study was to evaluate vascular endothelial function after intensive periodontal treatment, in hypertensive patients treated with angiotensinconverting enzyme inhibitors. A prospective, longitudinal, comparative study involving repeated measurements was conducted. Fifty-two consecutive patients with severe periodontal disease were divided into two groups, one comprising hypertensive patients treated with converting enzyme inhibitors and the other comprising patients with no clinical signs of pathology and not receiving angiotensin-converting enzyme inhibitors. Endothelial function was assessed by measuring postischemic dilation of the humeral artery (baseline echocardiography Doppler), and intensive periodontal treatment was performed 24h later. Endothelial function was re-assessed 24h and 15 days after periodontal treatment.
  
  
  METHODS
  Results were analyzed using the SPSS 20 statistical software package. Student's t test and MANOVA were calculated and linear regression analysis with 95% confidence intervals and α<0.05 was performed. Arterial dilation at 24 hours was lower compared to baseline in both groups; values corresponding to the groups receiving angiotensin-converting enzyme inhibitors were 11.89 ± 4.87 vs. 7.30 ± 2.90% (p<0.01) and those corresponding to the group not receiving ACE inhibitors were 12.72 ± 4.62 vs. 3.56 ± 2.39 (p<0.001). The differences between groups were statistically significant (p<0.001).
  
  
  CONCLUSIONS
  The increase in endothelial dysfunction after intensive periodontal treatment was significantly lower in hypertensive patients treated with angiotensin-converting enzyme inhibitors. Endothelial function improved 15 days after periodontal treatment, reaching baseline values. These results support the protective effect of angiotensin converting enzyme inhibitors on the endothelial function after intensive periodontal treatment.
authors.affiliation: Department of Buccodental Pathology, School of Dentistry, University of Buenos Aires, Argentina.|Spanish Hospital of Buenos Aires. Buenos Aires, Argentina.
authors.forename: María C
authors.initials: MC
authors.lastname: Rubio
authors.affiliation: Department of Buccodental Pathology, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Pablo G
authors.initials: PG
authors.lastname: Lewin
authors.affiliation: Department of Periodontics, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Griselda
authors.initials: G
authors.lastname: De la Cruz
authors.affiliation: Department of Periodontics, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Andrea N
authors.initials: AN
authors.lastname: Sarudiansky
authors.affiliation: Department of Periodontics, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Nieto
authors.affiliation: Department of Periodontics, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Osvaldo R
authors.initials: OR
authors.lastname: Costa
authors.affiliation: Spanish Hospital of Buenos Aires, Buenos Aires, Argentina. lnicolosi@hotmail.com.|Department of Buccodental Pathology, School of Dentistry, University of Buenos Aires, Argentina.
authors.forename: Liliana N
authors.initials: LN
authors.lastname: Nicolosi
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications / Q000601:surgery*; D011446:Prospective Studies
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
keywords: Hypertension; angiotensin-converting enzyme inhibitors; periodontal diseases