Gum Disease and High Blood Pressure: The Age and Inflammation Connection
Uncovering Hidden Links Between Oral Health and Systemic Disease
Periodontitis, a common inflammatory disease affecting the gums and supporting structures of the teeth, is already known to be closely related to hypertension (high blood pressure). However, the exact role that a patient's age and overall systemic inflammation play in strengthening this association has been unclear.
A cross-sectional clinical study conducted by Hongjia Yang and colleagues aimed to shed light on this relationship. They investigated how age and the body's inflammatory status influence the link between the severity of periodontitis and blood pressure in patients already diagnosed with periodontitis.
What the Researchers Did
The study involved 144 periodontitis patients treated at Beijing Chaoyang Hospital between January 2020 and July 2023.
The researchers gathered several key data points from the patients:
Periodontal indicators: Specifically focusing on the Percentage of Site with Bleeding on Probing (PBOP) as a measure of periodontitis severity.
Blood pressure: Both systolic blood pressure (SBP) and diastolic blood pressure (DBP).
Systemic Inflammation: Calculated using the Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI), derived from complete blood count and blood biochemistry data.
They used linear regression analyses to find the correlation between PBOP and SBP, adjusting for various confounding factors like age, sex, body mass index (BMI), smoking, drinking, and diabetes. Crucially, they used interaction analysis to explore how age and systemic inflammation specifically modify the relationship between the severity of gum disease and hypertension.
Key Findings: Age and Inflammation Boost the Risk
The study's most significant finding is that the severity of periodontitis, measured by PBOP, is strongly associated with Systolic Blood Pressure (SBP), and this link is significantly amplified by both increasing age and higher levels of systemic inflammation.
Here are the specific results:
Periodontitis and SBP: In the overall group, PBOP was significantly associated with SBP. The relationship was positive, meaning that as the severity of periodontitis increases (higher PBOP), SBP also tends to increase.
The Role of Age: The association between PBOP and SBP was only significant in patients aged 50 years or older. This indicates that age is a crucial factor modifying the link between gum disease and high blood pressure, with the risk of elevated SBP increasing as age increases.
The Role of Systemic Inflammation (SII and SIRI): The strength of the association between PBOP and SBP was greater in patients with a higher systemic immune-inflammation index (SII > 400) and a higher Systemic Inflammation Response Index (SIRI > 9). This suggests that as systemic inflammation levels rise, the correlation between periodontitis and SBP intensifies.
The researchers noted that Diastolic Blood Pressure (DBP) did not show a linear relationship with PBOP.
Implications and What Comes Next
This study suggests that for patients with periodontitis, the risk of having elevated SBP is significantly influenced by their age and underlying inflammatory status. This is the first report to demonstrate that the link between periodontitis severity and hypertension is modified by age and systemic inflammation.
The findings have important clinical implications:
Early Intervention: Since the risk of elevated SBP rises with age in periodontitis patients, the finding emphasizes the importance of early intervention for gum disease.
Holistic Care: Clinicians should pay special attention to a patient's overall inflammatory condition when treating periodontitis, especially in older patients.
However, as a cross-sectional study, it cannot establish a cause-and-effect relationship. Future research, particularly large-scale, long-term studies, is needed to explore the causal relationship, potential mechanisms, and whether improving periodontal health can effectively lower blood pressure.
Article Reference
Title: Effect of age and systemic inflammation on the association between severity of periodontitis and blood pressure in periodontitis patients.
Authors: Hongjia Yang, Yixuan Qin, Jiaqi Geng, et al.
Journal: BMC Oral Health (2025) 25:273