Associations of gingival inflammation with blood pressure among community-dwelling older women and men with periodontitis

Background Periodontitis and gingival inflammation are associated with chronic systemic inflammation which may cause elevation of blood pressure (BP). Purpose The aim was to assess sex-specific associations between clinical markers of gingival inflammation with systolic and diastolic BP in older women and men with periodontitis identified according to the European Federation of Periodontology/American Academy of Periodontology classification system. Methods Data from 704 women and 587 men with periodontitis, age 68-71 years, participating in the ‘Oral Health Survey’ of the Hordaland Health Studies was used. BP was measured three times in seated position after a minimum of 5 minutes rest, and the average of the two last measurements was taken as the clinic BP. Gingival inflammation was assessed by full-mouth registration of bleeding on probing (BoP) and probing pocket depths (PPD) ≥4 mm with BoP. Associations between BP and clinical markers of gingival inflammation (proportion of BoP and number of PPD ≥4 mm with BoP) were assessed in sex specific multivariable linear regression analyses adjusted for diabetes, smoking, body mass index, education and use of antihypertensive medication. Results Average BP was 129/73mmHg in men and 124/72 mmHg in women (p<0.01), and a higher proportion of men than women (41% vs 30% p<0.01) used antihypertensive medication. While the mean proportion of BoP was similar in women and men (0.36), the average number of PPD ≥4mm with BoP was higher in men (9 vs 6, p<0.05). Proportion of BoP and number of PPD ≥4 mm with BoP were both independently associated with higher diastolic BP in women, but not in men (both p for sex-interaction <0.05) (Table). Neither BoP nor PPD≥4 mm with BoP were associated with systolic BP in either sex. Conclusion Among older women and men with periodontitis, having more extensive and advanced gingival inflammation were associated with higher diastolic BP in women, but not in men.