Relationship between periodontal diseases and C-reactive protein among hypertensive patients under β-blocker antihypertensive drug (Clinical and Biochemical study)
Abstract
Background: Hypertension is the most important public health problem in the world and one of the major risk factors for cardio- vascular diseases, and it has been reported that hypertension is linked with periodontal diseases and both condition have reported to elevated levels of C-reactive protein.
Aims of the study:To determine the periodontal health status and the concentration of C-reactive protein in saliva among patients with hypertension and under β-blocker treatment and to compare the results with systemic healthy individuals, also to correlate the clinical findings with biochemical findings.
Materials and Methods: Test group consist of 25 hypertensive patients and under β-blocker treatment{Atenolol(Tenormin) 50 mg/day}, the test group further subdivided into three groups according to the duration of medication into: test I group under medication less than one year, test II group under medication between one to four years, test III group under medication more than four years.In addition to25 control group. Their age was between (40-45) years and all patients in both groups were male and non-smokers. Periodontal disease was evaluated by recording the plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level. Unstimulated salivary samples were collected and then chemically analyzed using high sensitivity ELISA to determine the concentration of C-reactive protein.
Results: The mean value of all recorded periodontal parameters were highest among test group compared to control with sta- tistically significant difference existed between both groups(p=0.001) for plaque index, (p=0.008) for gingival index, (p=0.006) for bleeding on probing, (p=0.017) for probing pocket depth, (p=0.002) for clinical attachment level.
In regard to the concentration of salivary C-reactive protein, the mean value was highest among test group compared to control with statistically non-significant differences between both groups(p=0.606).
The correlation coefficient between salivary C-reactive protein and periodontal parameters showed statistically non-significant correlation in both test group and control. Among test group, result revealed statistically significant correlation between salivary C-reactive protein and pocket depth among test group III (under medication more than four years)(p=0.039).
Conclusion:The study revealed poor condition of the oral cavities regarding the periodontal condition of patients with hyperten- sion, so the co-operation between general practitioners, cardiologists and dentists needs to be intensified. The concentrationsof salivary C-reactive protein of test groups were higher than control.
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Benigeri M, BrodeurJM, Payette M, Charbonneau A, Ismail A I. Community periodontal index of treat- ment needs and prevalence of periodontal conditions. J Clin Periodontol 2000 ;27: 308–312.
Hung H-C, Willett W, Merchant A, Rosner BA, Ascherio A, Joshipura K J. Oral health and peripheral arte- rial disease. Circulation 2003; 107:1152–1157.
Kearney PM, Whelton M, Reynolds K, Whelton PK, He J. Worldwide prevalence of hypertension: a sys- tematic review. J Hypertens 2004; 22: 11–19.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365:217–23.
Hajjar I, Kotchen JM, Kotchen TA . Hypertension: trend in prevalence, incidence and control .Annu Rev Public Health 2006; 27:465-90.
Inoue, K., Kobayashi, Y., Hanamura, H. , Toyokawa, S. Association of periodontitis with increased white blood cell count and blood pressure. Blood Pressure 2005; 14: 53–58.
Borges-Ya ́n ̃ez, S. A., Irigoyen-Camacho, M. E. , Maupome ́, G. Risk factors and prevalence of peri- odontitis in community-dwelling elders in Mexico. Journal of Clinical Periodontology 2006; 33: 184–194.
Vo ̈lzke H,Schwahn C, Do ̈rr M,Aumann N, Felix S B, John U, Rettig R, Do ̈ren M,Biffar R, Kocher T. Inverse association between number of teeth and left ventricular mass in women. Journal of Hyperten-
sion2007; 25: 2035–2043.
Ioi H,Nakata S,Nakasima A, Counts AL, Nanda RS . Changes in tooth position in humans in relation to
arterial blood pressure. Arch Oral Biol 2002; 47:219–226.
Aps J K M, Martens L C. Review: the physiology of saliva and transfer of drug into saliva. Forensic SciInt
; 150:119-31.
Loos BG, Craandijk J, Hoek FJ, Wertheim-van Dillen PM, van der Velden U. Elevation of systemic mark-
ers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J Periodontol 2000
;10:1528-1534.
Kiechl S, Egger G, Mayr M, et al. Chronic infections and the risk of carotid atherosclerosis: Prospective
results from a large population study. Circulation 2001;103;8:1064- 1070.
Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, et al. . Periodontal infections contribute to elevated
systemic C-reactive protein level. J Periodontol 2001; 72;9:1221-1227.
Ford ES, Giles WH, Myers GL, et al . C-reactive protein concentration distribution among US children
and young adults: findings from the National Health and Nutrition Examination Survey, 1999–2000.
ClinChem 2003 ; 49:1353–7.
Silness J, Loe H. Periodontal disease in pregnancy (II): Correlation between oral hygiene and periodontal
conditions. Octa Odontol Scand 1964; 22:121-35.
Loe H, Silness J. Periodontal disease in pregnancy I. Prevalence and severity. Octa Odontol Scand
;21:533-551
Sesso HD, Buring JE, Rifai N, Blake GJ, Gaziano JM, Ridker PM. C-reactive protein and the risk of de-
velopinghypertension. JAMA 2003; 290: 2945–2951.
Sung KC, Suh JY, Kim BS, Kang JH, Kim H, Lee MH, Park JR, Kim SW. High sensitivity C-reactive
protein as an independent risk factor for essential hypertension. Am J Hypertens.2003 ;16:429–433.
Valentaviciene G, Anuseviciene OV, Paipaliene P, Nedzelskiene I .Oral Health Status in the Participants of the“Juvenile Hypertension Program 2002”Stomatologija, Baltic Dental and Maxillofacial Journal 2004;
:24-27.
TsakosG, Sabbah W, Hingorani AD, Netuveli G, Donos N, Watt RG, et al . Is periodontal inflammation as-
sociated with raised blood pressure? Evidence from a National US survey. J Hypertens 2010; 28:2386–2393.
Holmlund A, Holm G, Lind L. Severity of periodontal disease and number of remaining teeth are related to the prevalence of myocardial infarction and hypertension in a study based on 4,254 subjects. J Peri-
odontol 2006;77:1173-1178.
Engstrom S, Gahnberg L, Hogberg H, Svardsudd K. Association between high blood pressure and deep
periodontal pockets: a nested case-referent study. Ups J Med Sci 2007;112:95-103.
Al-Safi A. Biochemical, Immunological and Histochemical study of cyclosporine-A induced gingival enlargement in kidney transplanted patients. A Ph.D Thesis. College of Dentistry, University of Bagh-
dad.2007; P:54-56.
DOI: http://dx.doi.org/10.26477/idj.v34i2.164
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