Sharma, S;
Sridhar, S;
McIntosh, A;
Messow, CM;
Aguilera, EM;
Del Pinto, R;
Pietropaoli, D;
... Czesnikiewicz-Guzik, M; + view all
(2021)
Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis.
Pharmacological Research
, 166
, Article 105511. 10.1016/j.phrs.2021.105511.
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Abstract
Aim: Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. / Materials and methods: A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). / Results: The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was −4.3 mmHg [95%CI: −9.10–0.48], p = 0.08 and −3.16 mmHg [95%CI: −6.51–0.19], p = 0.06 respectively. These studies were characterized by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD = −11.41 mmHg (95%CI: −13.66, −9.15) P < 0.00001] and DBP [WMD = −8.43 mmHg (95%CI: −10.96,−5.91)P < 0.00001] after IPT vs CPT among prehypertensive/hypertensive patients, while this was not observed in normotensive individuals. The meta-analyses showed significant reductions in CRP and improvement of endothelial function following IPT at all analysed timepoints. / Conclusions: IPT leads to improvement of the cardiovascular health in hypertensive and prehypertensive individuals.
| Type: | Article |
|---|---|
| Title: | Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.phrs.2021.105511 |
| Publisher version: | http://dx.doi.org/10.1016/j.phrs.2021.105511 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Periodontitis; Hypertension; Endothelial dysfunction; Inflammation; LDLCRP |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute > Restorative Dental Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10124426 |
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