School of Dentistry, University of Leeds, Leeds, UK.
Oral Biology, School of Dentistry, University of Leeds, Leeds, UK.
J Periodontol. 2022 Jul;93(7):1024-1035. doi: 10.1002/JPER.21-0621. Epub 2022 May 27.
Recent evidence suggests that periodontitis (PD) causes hypertension, which is a precursor to development of other systemic diseases. The aim of this study was to examine the effect of hypertension and PD on the risk of subsequent systemic disease.
This longitudinal cohort study included 244,393 UK Biobank participants who were free of systemic disease other than hypertension at baseline. Self-reported responses of painful gums or loose teeth were surrogates for PD. Hypertensives were identified by clinical diagnosis, or elevated blood pressure (≥140/90 mmHg). Systemic diseases including cancer, cardiovascular disease (CVD), and diabetes were identified from linked diagnostic codes. Multivariable Cox proportional hazard models were used to quantify the risk of systemic diseases and all-cause mortality, stratified by hypertensive and PD status.
The average age of the study population was 55.4 years (standard deviation [SD:] 8.1 years), and 130,220 (53.3%) participants were female. At baseline, 131,566 (53.8%) participants were hypertensive and 4.5% reported PD. The incidence rates of all systemic diseases were higher in hypertensive than non-hypertensive participants of the same PD status. In hypertensives, an additive effect was observed for PD on the risks of CVD (adjusted hazard ratio [HR]: 1.35, 95% confidence interval [CI]: 1.21-1.53) and respiratory disease (HR: 1.11, 95% CI: 0.95-1.30) compared to hypertensive healthy controls.
Hypertensives with PD have exacerbated risks of several systemic diseases. Future interventional studies should consider the effect of periodontal treatment on systemic outcomes in targeted hypertensive populations.
最近的证据表明，牙周炎（PD）会导致高血压，而高血压是其他全身性疾病发展的前兆。本研究旨在探讨高血压和 PD 对随后发生全身性疾病的风险的影响。
这项纵向队列研究纳入了 244393 名英国生物库参与者，他们在基线时除高血压外没有其他全身性疾病。自述牙龈疼痛或牙齿松动是 PD 的替代指标。高血压通过临床诊断或血压升高（≥140/90mmHg）来确定。从相关诊断代码中确定了包括癌症、心血管疾病（CVD）和糖尿病在内的全身性疾病。多变量 Cox 比例风险模型用于量化高血压和 PD 状态分层后的全身性疾病和全因死亡率风险。
研究人群的平均年龄为 55.4 岁（标准差[SD]：8.1 岁），130220 名（53.3%）参与者为女性。基线时，131566 名（53.8%）参与者患有高血压，4.5%的人报告有 PD。在高血压患者中，与 PD 状态相同的非高血压参与者相比，所有全身性疾病的发病率都更高。在高血压患者中，与高血压健康对照组相比，PD 对 CVD（调整后的危险比[HR]：1.35，95%置信区间[CI]：1.21-1.53）和呼吸系统疾病（HR：1.11，95%CI：0.95-1.30）的风险有累加效应。
患有 PD 的高血压患者发生几种全身性疾病的风险增加。未来的干预性研究应考虑牙周治疗对目标高血压人群的系统性结局的影响。
