Periodontal therapy and treatment of hypertension – alternative to the pharmacological approach. A systematic review and meta-analysis

Sharma, S. et al. (2021) Periodontal therapy and treatment of hypertension – alternative to the pharmacological approach. A systematic review and meta-analysis. Pharmacological Research, 166, 105511. (doi: 10.1016/j.phrs.2021.105511) (PMID:33617973)

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 characterised 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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Messow, Dr Martina and Maffia, Professor Pasquale and Sharma, Shiv and McIntosh, Dr Alasdair and Guzik, Professor Tomasz and Czesnikiewicz-Guzik, Dr Marta and Siedlinski, Mr Mateusz
• Authors: Sharma, S., Sridhar, S., Mcintosh, A., Messow, C.-M., Aguilera, E. M., Del Pinto, R., Pietropaoli, D., Górska, R., Siedlinski, M., Maffia, P., Tomaszewski, M., Guzik, T. J., D’aiuto, F., and Czesnikiewicz-Guzik, M.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Research Centre: College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
• Journal Name: Pharmacological Research
• Publisher: Elsevier
• ISSN: 1043-6618
• ISSN (Online): 1096-1186
• Published Online: 19 February 2021
• Copyright Holders: Copyright © 2021 Elsevier Ltd.
• First Published: First published in Pharmacological Research 166: 105511
• Publisher Policy: Reproduced in accordance with the publisher copyright policy