Self-reported periodontal health and incident hypertension: longitudinal evidence from the NutriNet-Santé e-cohort.

Objective An association between periodontitis and arterial hypertension has been suggested recently. This study aimed at investigating the hypothesis that periodontal health is linked to incident arterial hypertension. Methods We analyzed data from the French population-based e-cohort NutriNet-Sante, selecting participants who had completed two oral health questionnaires in 2011-2012. Pregnant women, participants with diabetes, cancer, arterial hypertension and cardiovascular diseases at inclusion were excluded. Incident cases of arterial hypertension were self-reported and/or based on the use of antihypertensive therapy. Periodontal health was evaluated by estimating the modified and validated PEriodontal Screening Score (mPESS), with mPESS at least 5 corresponding to a high probability of severe periodontitis. Descriptive statistics and Cox proportional hazards regression models, taking into account sociodemographic and lifestyle confounders, were used. Results The study population consisted of 32 285 participants (mean age: 45.79 ± 13.87 years); 78.5% were women. Two thousand one hundred and sixteen incident cases of arterial hypertension were identified during a median follow-up of 8 years (April 2012--December 2019). In the fully adjusted model, an mPESS at least 5 [hazard ratio: 1.84; 95% confidence interval (CI): 1.66-2.03] and the presence of nonreplaced missing teeth (hazard ratio: 1.13; 95% CI: 1.03-1.23) were significantly associated with a greater risk of incident arterial hypertension, whereas a regular annual visit to the dentist was associated with a lower risk (hazard ratio: 0.88; 95% CI: 0.80-0.97). Conclusion Self-reported assessed periodontitis was associated with incident arterial hypertension over an 8-year period. The present results highlight the importance of considering periodontal health when assessing an individual's risk of arterial hypertension. Trial registration # NCT03335644.