Assessment of the prognosis of cardiovascular risks in individuals with arterial hypertension and oral inflammatory processes

• Irina A. Lebedeva
• Guram N. Magradze
• Sergey A. Partsernyak
• Vitaly S. Ustyuzhaninov
• Aleksandr S. Partsernyak

Abstract

It is established that the presence of inflammatory processes of the oral cavity increases the cardiovascular risk. Paradontal pathology, which leads to increased expression of proinflammatory cytokines, affects the atherosclerosis initiation, endothelial dysfunction, vasospasm, and blood pressure dysregulation. It can be assumed that the inflammatory processes of the oral cavity against the background of arterial hypertension increase the likelihood of other cardiovascular diseases and the overall cardiovascular risk due to common pathogenesis factors. Currently, there are no clear algorithms for the diagnosis and management of patients with arterial hypertension and inflammatory processes of the oral cavity.

The aim of the study was to identify cardiovascular risk factors in individuals with a combination of arterial hypertension and periodontitis with a targeted assessment of the cytokine profile of the subjects. A correlation was shown between the degree of periodontal inflammation in men with arterial hypertension and the presence of polymorbid cardiovascular diseases and metabolic disorders, which was confirmed by the detected cytokine imbalance.

Keywords:comorbid pathology, periodontitis, arterial hypertension, interleukins, pro-inflammatory and antiinflammatory cytokines, atherosclerosis, dyslipidemia, blood pressure variability

References

1. Ten leading causes of death in the world. In: World Health Organization: information bulletins [Electronic resource]. 2018. 24 May. URL: https://www.who.int/ru/news-room/fact-sheets/detail/the-top-10-causes-of-death (date of access April 01, 2020) (in Russian)

2. Gay I.C., Tran D.T., Cavender A.C., Weltman R., Chang J., Luckenbach E., et al. The effect of periodontal therapy on glycaemic control in a Hispanic population with type 2 diabetes: a randomized controlled trial. J Clin Periodontol. 2014; 41: 673–880.

3. Partsernyak S.A., Yunatskevich P.I. Vegetosis: diseases of stress. Saint Petersburg: Sentyabr’, 2002: 424 p. (in Russian)

4. Sharabchiev Yu.T., Antipov V.V., Antipova S.I. Comorbidity – actual scientific and scientific-practical problem of medicine of the XXI century. Meditsinskie novosti [Medical News]. 2014; (8): 6–11. (in Russian)

5. Linden G.J., Lyons A., Scannapieco F.A. Periodontal systemic associations: review of the evidence. J Periodontol. 2013; 84: 8–19.

6. Kocher Т., König J., Borgnakke W.S., Pink C., Meisel P. Periodontal complications of hyperglycemia/diabetes mellitus: epidemiologic complexity and clinical challenge. Periodontology 2000. 2018; 78 (1): 59–97.

7. Aguilar-Salinas C.A., Viveros-Ruiz T. Recent advances in managing/understanding the metabolic syndrome. F1000Research. 2019; 8 (F1000 Faculty Rev): 370. Epub 2019 Apr 3. DOI: https://doi.org/10.12688/f1000research.17122.1

8. Makkar H., Reynold M.A., Wadhawan A., Dagdag A., Merchant A.T., Postolache T.T. Periodontal, metabolic, and cardiovascular disease: exploring the role of inflammation and mental health. Pteridines. 2018; 29: 124–63.

9. Bale B.F., Doneen A.L.,Vigerust D.J. High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis. Postgrad Med J. 2017; 93: 215–20.

10. Cannizzo E.S., Clement C.C., Sahu R., et al. Oxidative stress, inflamm-aging and immunosenescence. J Proteomics. 2011; 74 (11): 2313–23.

11. Kaptoge S., di Angelantonio E., Lowe G., et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010; 375 (9709): 132–40.

12. Dietrich T., Sharma P., Walter C., Weston P., Beck J. The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. J Clin Periodontol. 2013; 40: 70–84. DOI: https://doi.org/10.1111/jcpe.12062

13. Ridker P.M., Rifai N., Stampfer M.J., Hennekens C.H. Plasma concentration of interleukin-6 and the risk of future myocardial infarction among apparently healthy men. Circulation. 2000; 101: 1767–72.

14. Howcroft T.K., Campisi J., Louis G.B. The role of inflammation in age-related disease. Aging. 2013; 5 (1): 84–93.

15. Martins C.M., Sasaki H., Hirai K., Andrada A.C., Gomes-Filho J.E. Relationship between hypertension and periapical lesion: an in vitro and in vivo study. Braz Oral Res. 2016; 30 (1): 78. DOI: https://doi.org/10.1590/1807-3107BOR-2016.vol30.0078

16. Rashmi N., Galhotra V., Goel P., Rajguru J.P., Jha S.K., Kulkarni K. Assessment of C-reactive proteins, cytokines, and plasma protein levels in hypertensive patients with apical periodontitis. J Contemp Dent Pract. 2017; 18 (6): 516–21.

17. Solov’yov M.M., Yaryomenko A.I., Orekhova L.Yu. «The syndrome of psycho-sensory-anatomical-functional maladaptation» in the medical and educational process at the Faculty of Dentistry of the First St. Petersburg State Medical University named after I.P. Pavlov. In: A.I. Yaryomenko (ed.). Manual for Students of the II –V Courses of the Faculty of Dentistry. Saint-Petersburg: Izdatel’stvo SPbGMU im. akad. I.P. Pavlova, 2014: 24 p. (in Russian)

18. Winning L., Patterson C.C., Linden K., Evans A., Yarnel J., McKeown P.P., et al. Periodontitis and risk of prevalent and incident coronary heart disease events. J Clin Periodontol. 2020; 47 (12): 1446–56. Epub 2020 Nov 9. DOI: https://doi.org/10.1111/jcpe.13377

19. Dominy S.S., Lynch C., Ermini F., Benedyk M., Marczyk A., Konradi A., et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Sci Adv. 2019; 5: 3333.

20. Reyes L., Herrera D., Kozarov E., Roldan S., Progulske-Fox A. Periodontal bacterial invasion and infection: contribution to atherosclerotic pathology. J Clin Periodontol. 2013; 40 (suppl 14): 30–50.

21. Garrido M., Cárdenas A.M., Astorga J., Quinlan F., Valdés M., Chaparro A., et al. Elevated systemic inflammatory burden and cardiovascular risk in young adults with endodontic apical lesions. J Endod. 2019; 45 (2): 111–5. DOI: https://doi.org/10.1016/j.joen.2018.11.014

22. Muñoz Aguilera E., Suvan J., Buti J., Czesnikiewicz-Guzik M., Barbosa Ribeiro A., Orlandi M., et al. Periodontitis is associated with hypertension: a systematic review and meta-analysis. Cardiovasc Res. 2020; 116 (1): 28–39. DOI: https://doi.org/10.1093/cvr/cvz201

23. Pietropaoli D., Del Pinto R., Ferri C., Marzo G., Giannoni M., Ortu E., et al. Association between periodontal inflammation and hypertension using periodontal inflamed surface area and bleeding on probing. J Clin Periodontol. 2020; 47 (2): 160–72. DOI: https://doi.org/10.1111/jcpe.13216

24. Gordon J.H., LaMonte M.J., Genco R.J., Zhao J., Cimato T.R., Hovey K.M., et al. Association of clinical measures of periodontal disease with blood pressure and hypertension among postmenopausal women. J Periodontol. 2018; 89 (10): 1193–202. Epub 2018 Aug 15. DOI: https://doi.org/10.1002/JPER.17-0562

25. Partsernyak A.S., Khalimov Yu.Sh. Chronic inflammation and premature aging – two parallel processes in polymorbid cardiovascular pathology. Vestnik Rossiyskoy voenno-meditsinskoy akademii [Bulletin of the Russian Military Medical Academy]. 2019; 3 (67): 78–81. (in Russian)

All articles in our journal are distributed under the Creative Commons Attribution 4.0 International License (CC BY 4.0 license)