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Complete tooth loss linked to hypertension

Complete tooth loss linked to hypertension

Publication date: Thursday, 17 January 2019

Postmenopausal women who suffer complete tooth loss may be at higher risk of developing future hypertension. A recent study that edentulism (complete tooth loss) may serve as an early warning sign for increased hypertension risk.

Previous studies have suggested an association between periodontal disease and hypertension although the relationship remains unclear. Complete edentulism has been found to be associated with coronary heart disease, stroke, and all-cause mortality.

Study participants were 36,692 postmenopausal women in the Women's Health Initiative (WHI) -Observational Study, in the USA, who were followed annually from initial periodontal assessment in 1998 through 2015 for newly diagnosed hypertension. The WHI included women between 50-79 years enrolled at 40 sites in the USA between 1993 and 1998.

Postmenopausal women with tooth loss had a 20% increased risk of developing hypertension than other women participating in the study (adjusted HR 95% CI = 1.21 (1.11-1.30). The association was stronger among those 60 years compared to ≥60 years (p interaction 0.04) and among those with 120 mmHg systolic blood pressure, compared to those with ≥120 mm Hg (p iteraction 0.004). However, no association was found between peiodontal disease and hypertension.

The study authors suggested several possible reasons for the observed association. One possible explanation is that as people lose teeth, they may change their diets to softer and more processed foods. These changes in dietary patterns could be associated with higher risk of hypertension.


Improved dental hygiene in people at risk of tooth loss and preventive measures for those with tooth loss (including increased blood pressure monitoring, dietary modification, physical activity and weight loss) may be appropriate to reduce disease burden of hypertension. Further studies are needed to clarify these results and further elucidate a potential role of periodontal conditions on hypertension risk.

Gordon J, et al. Association of periodontal disease and edentulism with hypertension risk in postmenopausal women. Am J Hypertension 2019;32(2):193-201.



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Topics covered:
Category: Evidence in Practice
Edition: Volume 4 Number 1 PCCJ Online 2019

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