Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women

Joshua H. Gordon, Michael J. LaMonte, Jiwei Zhao, Robert J. Genco, Thomas R. Cimato, Kathleen M. Hovey, Matthew A. Allison, Charles Mouton, Jean Wactawski-Wende

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Multiple cross-sectional epidemiologic studies have suggested an association between periodontal disease and tooth loss and hypertension, but the temporality of these associations remains unclear. The objective of our study was to evaluate the association of baseline self-reported periodontal disease and edentulism with incident hypertension. METHODS: Study participants were 36,692 postmenopausal women in the Women's Health Initiative-Observational Study who were followed annually from initial periodontal assessment (1998-2003) through 2015 (mean follow-up 8.3 years) for newly diagnosed treated hypertension. Cox proportional hazards regression with adjustment for potential confounders was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Edentulism was significantly associated with incident hypertension in crude (HR (95% CI) = 1.38 (1.28-1.49)) and adjusted (HR (95% CI) = 1.21 (1.11-1.30)) models. This association was stronger among those <60 years compared to ≥60 years (P interaction 0.04) and among those with <120 mm Hg systolic blood pressure, compared to those with ≥120 mm Hg (P interaction 0.004). No association was found between periodontal disease and hypertension. CONCLUSIONS: These findings suggest that edentulous postmenopausal women may represent a group with higher risk of developing future hypertension. As such improved dental hygiene among those at risk for tooth loss as well as preventive measures among the edentulous such as closer blood pressure monitoring, dietary modification, physical activity, and weight loss may be warranted 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.

Original languageEnglish (US)
Pages (from-to)193-201
Number of pages9
JournalAmerican Journal of Hypertension
Volume32
Issue number2
DOIs
StatePublished - Jan 15 2019

Fingerprint

Periodontal Diseases
Hypertension
Tooth Loss
Confidence Intervals
Blood Pressure
Diet Therapy
Oral Hygiene
Women's Health
Observational Studies
Weight Loss
Epidemiologic Studies
Cross-Sectional Studies
Exercise

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Gordon, J. H., LaMonte, M. J., Zhao, J., Genco, R. J., Cimato, T. R., Hovey, K. M., ... Wactawski-Wende, J. (2019). Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women. American Journal of Hypertension, 32(2), 193-201. https://doi.org/10.1093/ajh/hpy164

Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women. / Gordon, Joshua H.; LaMonte, Michael J.; Zhao, Jiwei; Genco, Robert J.; Cimato, Thomas R.; Hovey, Kathleen M.; Allison, Matthew A.; Mouton, Charles; Wactawski-Wende, Jean.

In: American Journal of Hypertension, Vol. 32, No. 2, 15.01.2019, p. 193-201.

Research output: Contribution to journalArticle

Gordon, JH, LaMonte, MJ, Zhao, J, Genco, RJ, Cimato, TR, Hovey, KM, Allison, MA, Mouton, C & Wactawski-Wende, J 2019, 'Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women', American Journal of Hypertension, vol. 32, no. 2, pp. 193-201. https://doi.org/10.1093/ajh/hpy164
Gordon, Joshua H. ; LaMonte, Michael J. ; Zhao, Jiwei ; Genco, Robert J. ; Cimato, Thomas R. ; Hovey, Kathleen M. ; Allison, Matthew A. ; Mouton, Charles ; Wactawski-Wende, Jean. / Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women. In: American Journal of Hypertension. 2019 ; Vol. 32, No. 2. pp. 193-201.
@article{185fc977b55c40d793439128d876941c,
title = "Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women",
abstract = "BACKGROUND: Multiple cross-sectional epidemiologic studies have suggested an association between periodontal disease and tooth loss and hypertension, but the temporality of these associations remains unclear. The objective of our study was to evaluate the association of baseline self-reported periodontal disease and edentulism with incident hypertension. METHODS: Study participants were 36,692 postmenopausal women in the Women's Health Initiative-Observational Study who were followed annually from initial periodontal assessment (1998-2003) through 2015 (mean follow-up 8.3 years) for newly diagnosed treated hypertension. Cox proportional hazards regression with adjustment for potential confounders was used to calculate hazard ratios (HRs) and 95{\%} confidence intervals (CIs). RESULTS: Edentulism was significantly associated with incident hypertension in crude (HR (95{\%} CI) = 1.38 (1.28-1.49)) and adjusted (HR (95{\%} CI) = 1.21 (1.11-1.30)) models. This association was stronger among those <60 years compared to ≥60 years (P interaction 0.04) and among those with <120 mm Hg systolic blood pressure, compared to those with ≥120 mm Hg (P interaction 0.004). No association was found between periodontal disease and hypertension. CONCLUSIONS: These findings suggest that edentulous postmenopausal women may represent a group with higher risk of developing future hypertension. As such improved dental hygiene among those at risk for tooth loss as well as preventive measures among the edentulous such as closer blood pressure monitoring, dietary modification, physical activity, and weight loss may be warranted 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.",
author = "Gordon, {Joshua H.} and LaMonte, {Michael J.} and Jiwei Zhao and Genco, {Robert J.} and Cimato, {Thomas R.} and Hovey, {Kathleen M.} and Allison, {Matthew A.} and Charles Mouton and Jean Wactawski-Wende",
year = "2019",
month = "1",
day = "15",
doi = "10.1093/ajh/hpy164",
language = "English (US)",
volume = "32",
pages = "193--201",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "2",

}

TY - JOUR

T1 - Association of Periodontal Disease and Edentulism With Hypertension Risk in Postmenopausal Women

AU - Gordon, Joshua H.

AU - LaMonte, Michael J.

AU - Zhao, Jiwei

AU - Genco, Robert J.

AU - Cimato, Thomas R.

AU - Hovey, Kathleen M.

AU - Allison, Matthew A.

AU - Mouton, Charles

AU - Wactawski-Wende, Jean

PY - 2019/1/15

Y1 - 2019/1/15

N2 - BACKGROUND: Multiple cross-sectional epidemiologic studies have suggested an association between periodontal disease and tooth loss and hypertension, but the temporality of these associations remains unclear. The objective of our study was to evaluate the association of baseline self-reported periodontal disease and edentulism with incident hypertension. METHODS: Study participants were 36,692 postmenopausal women in the Women's Health Initiative-Observational Study who were followed annually from initial periodontal assessment (1998-2003) through 2015 (mean follow-up 8.3 years) for newly diagnosed treated hypertension. Cox proportional hazards regression with adjustment for potential confounders was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Edentulism was significantly associated with incident hypertension in crude (HR (95% CI) = 1.38 (1.28-1.49)) and adjusted (HR (95% CI) = 1.21 (1.11-1.30)) models. This association was stronger among those <60 years compared to ≥60 years (P interaction 0.04) and among those with <120 mm Hg systolic blood pressure, compared to those with ≥120 mm Hg (P interaction 0.004). No association was found between periodontal disease and hypertension. CONCLUSIONS: These findings suggest that edentulous postmenopausal women may represent a group with higher risk of developing future hypertension. As such improved dental hygiene among those at risk for tooth loss as well as preventive measures among the edentulous such as closer blood pressure monitoring, dietary modification, physical activity, and weight loss may be warranted 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.

AB - BACKGROUND: Multiple cross-sectional epidemiologic studies have suggested an association between periodontal disease and tooth loss and hypertension, but the temporality of these associations remains unclear. The objective of our study was to evaluate the association of baseline self-reported periodontal disease and edentulism with incident hypertension. METHODS: Study participants were 36,692 postmenopausal women in the Women's Health Initiative-Observational Study who were followed annually from initial periodontal assessment (1998-2003) through 2015 (mean follow-up 8.3 years) for newly diagnosed treated hypertension. Cox proportional hazards regression with adjustment for potential confounders was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Edentulism was significantly associated with incident hypertension in crude (HR (95% CI) = 1.38 (1.28-1.49)) and adjusted (HR (95% CI) = 1.21 (1.11-1.30)) models. This association was stronger among those <60 years compared to ≥60 years (P interaction 0.04) and among those with <120 mm Hg systolic blood pressure, compared to those with ≥120 mm Hg (P interaction 0.004). No association was found between periodontal disease and hypertension. CONCLUSIONS: These findings suggest that edentulous postmenopausal women may represent a group with higher risk of developing future hypertension. As such improved dental hygiene among those at risk for tooth loss as well as preventive measures among the edentulous such as closer blood pressure monitoring, dietary modification, physical activity, and weight loss may be warranted 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.

UR - http://www.scopus.com/inward/record.url?scp=85060016701&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85060016701&partnerID=8YFLogxK

U2 - 10.1093/ajh/hpy164

DO - 10.1093/ajh/hpy164

M3 - Article

VL - 32

SP - 193

EP - 201

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 2

ER -