Periodontal therapy and treatment of hypertension - alternative to the pharmacological approach. A systematic review and meta-analysis

Abstract Aim Quantitative comparison of the effects of intensive (IPT) or conventional (CPT) periodontal treatment on arterial blood pressure, endothelial function and inflammatory/metabolic biomarkers. Materials and Methods A systematic search was conducted to identify randomized controlled trials (RCT) of IPT (supra and subgingival instrumentation). Eight RCTs were included in the meta-analysis. Difference in change of systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after IPT or CPT were the primary outcomes. The secondary outcomes included: endothelial function and selected inflammatory/anti-inflammatory (CRP, IL-6, IL-10, IFN-γ) and metabolic biomarkers (HDL, LDL, TGs). Results The overall effect estimates (pooled Weighted Mean Difference (WMD)) of the primary outcome for SBP and DBP was -4.3 mmHg [95%CI: -9.10-0.48], p=0.08 and -3.16 mmHg [95%CI: -6.51-0.19], p=0.06 respectively. These studies were characterised by high heterogeneity. Therefore, random effects model for meta-analysis was performed. Sub-group analyses confirmed statistically significant reduction in SBP [WMD =-11.41 mmHg (95%CI: -13.66, -9.15) P Conclusions IPT leads to improvement of the cardiovascular health in hypertensive and prehypertensive individuals.