Access to dental care and blood pressure profiles in adults with high socioeconomic status

Pinto, R. D., Monaco, A., Ortu, E., Czesnikiewicz-Guzik, M. , Aguilera, E. M., Giannoni, M., D'Aiuto, F., Guzik, T. J., Ferri, C. and Pietropaoli, D. (2022) Access to dental care and blood pressure profiles in adults with high socioeconomic status. Journal of Periodontology, 93(7), pp. 1060-1071. (doi: 10.1002/jper.21-0439) (PMID:34726790)

[img] Text
258785.pdf - Published Version
Available under License Creative Commons Attribution.

500kB

Abstract

Background: Reduced access to dental care may increase cardiovascular risk; however, socioeconomic factors are believed to confound the associations. We hypothesized that the relation persists despite economic wellness and high education, with reduced access to dental care affecting cardiovascular risk at least in part through its effect on blood pressure (BP), possibly mediated by systemic inflammation. Methods: We first assessed the sociodemographic and clinical characteristics related to last dental visit timing (≤ or >6 months; self-reported) using national representative cross-sectional data. Then, the association of last dental visit timing with clinic BP was selectively investigated in highly educated, high income participants, further matched for residual demographic and clinical confounders using propensity score matching (PSM). The mediating effect of systemic inflammation was formally tested. Machine learning was implemented to investigate the added value of dental visits in predicting high BP over the variables included in the Framingham Hypertension Risk Score among individuals without an established diagnosis of hypertension. Results: Of 27,725 participants included in the population analysis, 46% attended a dental visit ≤6 months. In the PSM cohort (n = 2350), last dental visit attendance >6 months was consistently associated with 2 mmHg higher systolic BP (P = 0.001) and with 23 to 35% higher odds of high/uncontrolled BP compared with attendance ≤6 months. Inflammation mildly mediated the association. Access to dental care improved the prediction of high BP by 2%. Conclusions: Dental care use impacts on BP profiles independent of socioeconomic confounders, possibly through systemic inflammation. Regular dental visits may contribute to preventive medicine.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Guzik, Professor Tomasz and Czesnikiewicz-Guzik, Dr Marta
Authors: Pinto, R. D., Monaco, A., Ortu, E., Czesnikiewicz-Guzik, M., Aguilera, E. M., Giannoni, M., D'Aiuto, F., Guzik, T. J., Ferri, C., and Pietropaoli, D.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Journal Name:Journal of Periodontology
Publisher:Wiley
ISSN:0022-3492
ISSN (Online):1943-3670
Published Online:02 November 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Journal of Periodontology 93(7): 1060-1071
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record