DAMAGE TO TARGET ORGANS IN PATIENTS WITH ARTERIAL HYPERTENSION AND PERIODONTITIS

Highlights

Arterial hypertension is a key modifiable risk factor for cardiovascular diseases and premature mortality, in the pathogenesis of which inflammatory processes play a significant role. Periodontitis, as a chronic inflammatory disease, may be associated with elevated blood pressure and, in patients with hypertension, may increase the risk and severity of target organ damage. Therefore, it is important to study the impact of chronic inflammation associated with periodontitis on the course of hypertension, the degree of target organ damage, and the development of associated clinical conditions.

Aim. To determine the prevalence of associated clinical conditions and target organ damage in patients with arterial hypertension and periodontitis.

Methods. The study included 150 patients with AH, divided into two groups: with periodontitis (study group, 76 patients) and without periodontitis (control group, 74 patients). Clinical and laboratory parameters were assessed (age, BMI, smoking status, CRP, lipid profile, etc.), as well as target organ damage (left ventricular hypertrophy (LVH) by ECG and echocardiography, retinopathy) and arterial status (pulse wave velocity (PWV) and vascular age (VA)). The diagnosis of periodontitis was established in the presence of clinical attachment loss at two or more non-adjacent interproximal sites with a periodontal probing depth greater than 3 mm.

Results. In patients with concomitant AH and periodontitis, hypertension developed at an earlier age (47 years) compared with the group without periodontitis (50 years). Patients with periodontitis had higher levels of systemic inflammation (elevated hs-CRP: 5 mg/L vs 2 mg/L in the control group) and dyslipidemia (higher triglyceride levels). Patients with periodontitis demonstrated statistically significantly higher PWV and VA values, as well as a higher prevalence of LVH and predominance of concentric left ventricular hypertrophy. The prevalence of ACCs (type 2 diabetes mellitus (T2DM), coronary artery disease (CAD), myocardial infarction (MI), and acute cerebrovascular events (stroke)) was significantly higher in the periodontitis group.

Conclusions. Periodontitis in patients with arterial hypertension is associated with increased systemic inflammation, more pronounced target organ damage, and a higher risk of associated clinical conditions. Incorporating measures for the prevention and treatment of periodontitis may improve hypertension control and reduce its complications.

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