Periodontitis was associated with significantly reduced forearm blood flow responses to acetylcholine in healthy and hypertensive subjects, which improved after periodontal therapy.
Observational (n=114)
Does periodontitis impair endothelial function in healthy subjects and hypertensive patients, and does periodontal therapy improve it?
Periodontitis is associated with endothelial dysfunction via decreased nitric oxide bioavailability, which can be improved with periodontal therapy, suggesting systemic inflammation links periodontal and cardiovascular diseases.
The purpose of this study was to evaluate endothelial function in patients with periodontitis. We evaluated forearm blood flow responses to acetylcholine and sodium nitroprusside in patients with periodontitis who had no other cardiovascular risk factors (32 men; 25+/-3 years of age), in a normal control group (20 men; 26+/-3 years of age), and in hypertensive patients with periodontitis (28 men and 10 women; 56+/-12 years of age) and without periodontitis (control group; 18 men and 6 women; 54+/-13 years of age). Forearm blood flow was measured using strain-gauge plethysmography. Circulating levels of C-reactive protein and interleukin-6 were significantly higher in the periodontitis group than in the control group. Both in healthy and hypertensive subjects, forearm blood flow responses to acetylcholine were significantly smaller in the periodontitis group than in the control group. Sodium nitroprusside-stimulated vasodilation was similar in the 2 groups. Periodontal therapy reduced serum concentrations of C-reactive protein and interleukin-6 and augmented acetylcholine-induced vasodilation in periodontitis patients with and without hypertension. After administration of N(G)-monomethyl-L-arginine, an NO synthase inhibitor, forearm blood flow response to acetylcholine was similar before and after treatment. These findings suggest that periodontitis is associated with endothelial dysfunction in subjects without cardiovascular risk factors, as well as hypertensive patients, through a decrease in NO bioavailability and that systemic inflammation may be, at least in part, a cause of endothelial dysfunction, leading to cardiovascular diseases.
Higashi et al. (Tue,) conducted a observational in Periodontitis and Hypertension (n=114). Periodontitis (exposure) / Periodontal therapy vs. Subjects without periodontitis was evaluated on Forearm blood flow responses to acetylcholine and sodium nitroprusside. Periodontitis was associated with significantly reduced forearm blood flow responses to acetylcholine in healthy and hypertensive subjects, which improved after periodontal therapy.
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