The state of periodontum and cardiovascular risk factors in adolescents with high blood pressure

Abstract

Objective — To establish significant associations between periodontium status, circadian blood pressure (BP) profile and cardiovascular risk factors in adolescents with high BP. Material and Methods — The cross-sectional study involved 113 adolescents (78 boys) aged 10 to 17 years, with a BP level (during repeated office measurements) of ≥95 percentile for age, height and sex, or ≥140/90 mmHg in adolescents older than 16 years. All adolescents were subjected to 24-hour blood pressure monitoring, anthropometric measurements, laboratory blood tests (lipids, uric acid, alanine aminotransferase, aspartate aminotransferase, fasting glucose), echocardiography (left ventricular myocardial mass index, relative wall thickness), assessment of the stage of puberty, dental examination (complex periodontal index (CPI), oral hygiene index). The association between the periodontium status and cardiovascular risk factors was assessed using univariant and multiple regression analysis, adjusted by sex, age, Tanner stage, body mass index, and oral hygiene index. Results — Clinical features of periodontitis were found in 32.7% of adolescents. Multiple regression analysis showed the presence of significant associations of CPI with the levels of systolic, mean and pulse BP during 24 hours (β=0.42, р=0.0001; β=0.31, р=0.003 and β=0.26, р=0.018, respectively), diastolic BP in the daytime (β=0.23, р=0.019), as well as the indices of load with high systolic BP within 24 hours (β=0.42, р=0.0001) and diastolic BP in the daytime (β=0.25, р=0.006). None of the other cardiovascular risk factors showed meaningful relationships with periodontium status in the multivariate analysis. Conclusion — The relationship between periodontium status and blood pressure level exists already in adolescence. That may, on the one hand, justify assessment of periodontium status and (if necessary) timely implementation of prophylactic measures in adolescents with high blood pressure and, on the other hand, recommend BP assessment in adolescents with diagnosed periodontitis.