Inflammation and Hypertension - Literature Review

Research has confirmed the existence of an independent association between hypertension and inflammation (1), and that CRP levels are associated with the future development of hypertension. This suggests that hypertension is in part an inflammatory disorder (2).

Systemic inflammation and CRP is known to lead to endothelial dysfunction leading to arterial stiffness and wave reflection in asymptomatic subjects (3) in both acute and chronic inflammation.

This suggests that inflammation levels are predictive of future development of hypertension, and that sub-clinical systemic inflammation is linked to functional alterations of the arterial bed. Furthermore, when the inflammation becomes chronic, arterial stiffness is increased (4).

Since periodontal disease is a known risk factor for heart disease and has been demonstrated to increase systemic inflammatory markers (5), it is prudent for the physician to screen at-risk patients for gum disease and advise they receive appropriate dental treatment to control for this potential source of systemic inflammation.

Similarly when dentists and hygienists are dealing with patients who have periodontal disease they should monitor and question the patient for the presence of high blood pressure and other cardiovascular disease signs and symptoms, and make appropriate referrals to medical professionals for follow up care.

1- Lakoski S, et.al., The Relationship Between Blood Pressure and C-Reactive Protein in the Multi-Ethnic Study of Atherosclerosis. Am College of Cardiology  Vol. 46:10 , pp 1869-1874.

2-  Sesso HD, et.al., C-Reactive Protein and the Risk of Developing Hypertension.JAMA.2003;290:2945-2951

3- Kullo IJ et.al., C-Reactive Protein Is Related to Arterial Wave Reflection and Stiffness in Asymptomatic Subjects From the Community. Am J. of Hypertension Vol.18:8 , pp 1123-1129.

4- Ibid, Kullo

5- Mattila K, et.al., Effect of treating Periodontitis on CRP levels. BMC Infectious Diseases 2002, 2:30.