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Access to dental care and blood pressure profiles in adults with high socioeconomic status.
Del Pinto, Rita; Monaco, Annalisa; Ortu, Eleonora; Czesnikiewicz-Guzik, Marta; Muñoz Aguilera, Eva; Giannoni, Mario; D'Aiuto, Francesco; Guzik, Tomasz J; Ferri, Claudio; Pietropaoli, Davide.
Afiliación
  • Del Pinto R; Unit of Internal Medicine and Nephrology - Center for Hypertension and Cardiovascular Prevention - San Salvatore Hospital, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
  • Monaco A; Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.
  • Ortu E; Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.
  • Czesnikiewicz-Guzik M; Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Department of Life, Health and Environmental Sciences, Dental Clinic - University of L'Aquila, L'Aquila, Italy.
  • Muñoz Aguilera E; Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.
  • Giannoni M; Center for Oral Diseases, Prevention and Translational Research - San Salvatore Hospital, Department of Life, Health and Environmental Sciences, Dental Clinic - University of L'Aquila, L'Aquila, Italy.
  • D'Aiuto F; Department of Periodontology and Oral Sciences Research Group, University of Glasgow Dental School, Glasgow, UK.
  • Guzik TJ; Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University, Collegium Medicum, Krakow, Poland.
  • Ferri C; Periodontology Unit, UCL Eastman Dental Institute and Hospital, University College London, London, UK.
  • Pietropaoli D; Oral DISeases and SYstemic interactions study group (ODISSY group), L'Aquila, Italy.
J Periodontol ; 93(7): 1060-1071, 2022 07.
Article en En | MEDLINE | ID: mdl-34726790
BACKGROUND: Reduced access to dental care may increase cardiovascular risk; however, socioeconomic factors are believed to confound the associations. We hypothesized that the relation persists despite economic wellness and high education, with reduced access to dental care affecting cardiovascular risk at least in part through its effect on blood pressure (BP), possibly mediated by systemic inflammation. METHODS: We first assessed the sociodemographic and clinical characteristics related to last dental visit timing (≤ or >6 months; self-reported) using national representative cross-sectional data. Then, the association of last dental visit timing with clinic BP was selectively investigated in highly educated, high income participants, further matched for residual demographic and clinical confounders using propensity score matching (PSM). The mediating effect of systemic inflammation was formally tested. Machine learning was implemented to investigate the added value of dental visits in predicting high BP over the variables included in the Framingham Hypertension Risk Score among individuals without an established diagnosis of hypertension. RESULTS: Of 27,725 participants included in the population analysis, 46% attended a dental visit ≤6 months. In the PSM cohort (n = 2350), last dental visit attendance >6 months was consistently associated with 2 mmHg higher systolic BP (P = 0.001) and with 23 to 35% higher odds of high/uncontrolled BP compared with attendance ≤6 months. Inflammation mildly mediated the association. Access to dental care improved the prediction of high BP by 2%. CONCLUSIONS: Dental care use impacts on BP profiles independent of socioeconomic confounders, possibly through systemic inflammation. Regular dental visits may contribute to preventive medicine.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Hipertensión Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Periodontol Año: 2022 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Hipertensión Tipo de estudio: Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: J Periodontol Año: 2022 Tipo del documento: Article País de afiliación: Italia