歯周炎は高血圧と関連するか？

Is periodontitis associated with hypertension?

抄録

データ情報源 Cochrane Central Register of Controlled Trials (CENTRAL)、Medline (Ovid)、Embase、Web of Science、Latin American & Caribbean Health Sciences Literature (LILACS)、SIGLEデータベース。データは研究デザインに基づいて分類された。主要アウトカムは、歯周炎患者における高血圧のオッズ比（OR）/相対リスク（RR）および信頼区間（CI）とした。結果 中等度～重度歯周炎（OR = 1.22；95％CI：1.10～1.35）および重度歯周炎（OR = 1.49；95％CI：1.09～2.05）の診断は、高血圧と関連していた。歯周炎の診断により、高血圧の発症確率が上昇した（OR＝1.68；95％CI：0.85-3.35）。歯周炎患者では、平均収縮期血圧（加重平均差[WMD]4.49mmHg；95％CI：2.88-6.11）および拡張期血圧（2.03mmHg；95％CI：1.25-2.81）が高かった。歯周治療が血圧を低下させるという決定的なエビデンスは得られなかった（収縮期血圧で3～12.5mmHg、拡張期血圧で0～10mmHg）。さらに、歯周炎の管理は高血圧の管理に影響を与える可能性がある。しかし、より質の高い研究が必要である。

Data sources Cochrane Central Register of Controlled Trials (CENTRAL), Medline (Ovid), Embase, Web of Science, Latin American & Caribbean Health Sciences Literature (LILACS) and SIGLE database.Study selection Randomised controlled trials (RCTs), controlled clinical trials (CCTs), cohort studies, case-control studies and cross-sectional studies.Data extraction and synthesis Two reviewers screened papers independently and assessed the risk of bias. Data categorised based on the study design. The primary outcome was the odds ratio (OR)/relative risk (RR) and confidence interval (CI) for hypertension in individuals with periodontitis.Results Diagnoses of moderate-to-severe (OR = 1.22; 95% CI: 1.10-1.35) and severe periodontitis (OR = 1.49; 95% CI: 1.09-2.05) were associated with hypertension. Diagnosis of periodontitis increased odds of occurring hypertension (OR = 1.68; 95% CI: 0.85-3.35). Patients with periodontitis exhibited higher mean systolic (weighted mean difference [WMD] of 4.49 mmHg; 95% CI: 2.88-6.11) and diastolic blood pressures (2.03 mmHg; 95% CI: 1.25-2.81). There was inconclusive evidence that periodontal therapy reduces blood pressure (3-12.5 mmHg of systolic and 0-10 mmHg of diastolic blood pressures).Conclusions Periodontitis could be associated with increased risk of hypertension. Further, the management of periodontitis could impact on the management of hypertension. However, there is still a need for more high-quality research.