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)

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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 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:Czesnikiewicz-Guzik, Dr Marta and Siedlinski, Mr Mateusz and Messow, Dr Martina and Guzik, Professor Tomasz and Maffia, Professor Pasquale and McIntosh, Dr Alasdair
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 > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
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

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