Association of Periodontal Disease with Hypertension in Nigerian Patients: A Comparative Study

Background: Periodontal diseases are chronic and inflammatory in nature and have been associated with hypertension, a major risk factor for cardiovascular diseases. Hypertension is prevalent among Nigerians. However, controlled studies on the relationship between hypertension and periodontal disease in Nigeria are limited. Here, we investigated the relationship between periodontal diseases and hypertension among Nigerians.

Methods: This comparative, cross-sectional study assessed the periodontal clinical parameters and body mass index (BMI) of 75 hypertensives and 75 gender-matched normotensive controls in a teaching hospital in Lagos, Nigeria. Hypertension was categorized as blood pressure ≥140/90 mm Hg based on the WHO guidelines. Socio-demography, periodontal parameters, BMI, and blood pressure were documented in interviewer-administered questionnaires. Periodontal disease was assessed by the highest Community Periodontal Index (CPI) scores, CPI sextants, gingival index (GI), simplified oral hygiene index (OHIS), and the number of teeth with gingival recession. Hypertension was the dependent variable, while periodontal disease, obesity, and age were the independent variables. P values <0.05 were considered statistically significant.

Results: The mean CPI 3 sextant was significantly associated with hypertension (P<0.05). The independent predictors of hypertension were moderate gingival inflammation (OR 3.314, 95% CI 1.156-9.502, p=0.026), older age >60 years (OR 11.527, 95%CI 2.976-44.651, P<0.001), overweight/obesity (OR 3.279, 95%CI 1.414-7.602, P=0.006), and lower education (OR 3.070, 95% CI 1.288-7.319, P=0.011).

Conclusion: In addition to the known risk factors for hypertension, moderate gingivitis was a predictor of hypertension, while hypertensives had a greater extent of pockets than non-hypertensives. This study reiterates the association of preventable, low-grade periodontal inflammation with hypertension.