Are you controlling your high blood pressure, even with medication?
Open your mouth and say "Aha!" If you see tooth decay or gums that are sore, bleed or retreat. You have found the culprit.
Researchers reported Monday that in adults whose hypertension has been treated with medication, systolic blood pressure – which measures the pressure in the vessels when the heart beats – became higher when the health of their teeth and gums decreased  Compared to hypertensive patients who had no signs of periodontitis, those with inflamed gums were 20 percent less likely to have their blood pressure within healthy limits. In addition, patients with poor dental status had systolic blood pressure values that were on average 3 mm HG higher than similar healthy gums patients
The results were published in the journal Hypertension
three US adults ̵
The new study is in line with a research mountain that associates gum disease with higher heart rates. Blood vessel and kidney disease – all organs that are affected by high blood pressure. And it breaks new ground by showing how bad dental health drives efforts to fight hypertension.
In fact, the study found that people with untreated hypertension and healthy gums had blood pressures roughly equivalent to those taking medications
In other words, poor dental health largely negated the effects of taking blood pressure medication.
The new research does not show that gum disease causes high blood pressure and its negative health effects. Many researchers suggest that, like stiff blood vessels, inflamed and bleeding gums are just another manifestation of inflammation throughout the body.
The study also fails to show that the treatment of periodontal disease reduces hypertension.
When dental health is poor, the challenge of controlling blood pressure is more expensive and more likely to fail.
Italian researchers scoured the records of 11,753 Americans who participated in the National Health and Nutrition Survey in 2009 and 201 4 and were screened for periodontal disease. About 4,095 of the participants were diagnosed with hypertension, of which 88.5 percent were on medication for the disease and 11.5 percent were not.
The rates of moderate and severe periodontitis were among study participants, the males, elderly, Latino, smokers, and those with less income and education. Participants who were 65 years or older and had a long-standing periodontal disease were more likely to have uncontrolled high blood pressure than patients with less severe and prolonged gum disease, a trend that has been particularly prevalent in Latinos.
Both hypertension and periodontal disease are more common among African Americans and Latinos in the United States. These patient populations also show strikingly higher rates of the diseases associated with both, including heart disease, renal failure and cerebrovascular diseases such as stroke and certain forms of dementia.
There is some evidence that African Americans may have a genetic vulnerability to high blood pressure, but it is controversial. There is little doubt that access to health care varies by race and ethnicity, and that barriers to good medical and dental care play a crucial role in the disparity of racial and ethnic health problems.
Dental care is particularly expensive and far less likely to be fully insured than medical care. As a result, economic factors are likely to play a strong role in influencing the health of a patient's gums.
In addition, many GPs and cardiologists fail to ask their patients about their dental health or to hand them over to dentists if they are not undergoing heart surgery and have clear signs of tooth decay. And dentists do not necessarily check their patients' blood pressure.
The study authors wrote that patients with high blood pressure should consider their gum health when considering their treatment options.
"Our data suggest that all racial / ethnic subgroups, especially Hispanics, could benefit from such an approach," they wrote. "Conversely, ignoring the additional burden of poor periodontal status on blood pressure could lead to increased cardiovascular risk in the long term."
Charlene Niemi, director of health care at Care Harbor, a California-based charity that provides free medical, dental and visionary care at massive pop-up clinics across the state, said it was "imperative that People are aware that good oral care and treatment of gum disease play a role in blood pressure. "
While everyone needs regular dental checkups, "Those with high blood pressure should understand the importance of a dentist, seek routine aftercare, and practice good oral care," said Niemi. Connecting underserved patients to such routine care is an important task for Care Harbor.
At a time when the federal health insurance for the poor and disabled will be scaled back and the requirements of the Affordable Care Act abolished, it is unlikely that patients with gum disease will get better access to dental care in the near future.
But if so, then it could help, Dr. Gregg L. Fonarow, cardiologist at UCLA.
"It is suggested by these data, but that would have to be proven," said Fonarov.
In the meantime, he said, the presence of a compound is clear: patients with high blood pressure should do everything to improve their oral health, and those with poor gum health should be vigilant against hypertension.