Isolated Systolic Blood Pressure and Red-Complex Bacteria-A Risk for Generalized Periodontitis and Chronic Kidney Disease.

Jaideep Mahendra,Shankargouda Patil,Khalid J Alzahrani,Sruthi Srinivasan,Saranya Varadarajan,Little Mahendra,Plato Palathingal,Shilpa Bhandi,Janani Muralidharan,Maryam H Mugri,A Thirumal Raj,Mohammad Almagbol,Thodur Madapusi Balaji,Mohammed Sayed

doi:10.3390/microorganisms10010050

Abstract

Hypertension is a risk factor for generalized periodontitis (GP) and chronic kidney diseases (CKD). However, the role of isolated systolic blood pressure as one of the major risks for these inflammatory diseases has not been explored. Very limited studies exist identifying the red-complex bacteria in association with the isolated systolic blood pressure. Hence, the main objective of this study was to assess the isolated systolic blood pressure and the red-complex bacteria along with the demographic variables, periodontal parameters, and renal parameters in patients with generalized periodontitis and chronic kidney disease. One hundred twenty participants (age 30–70 years) were divided into four groups—Group C: control (systemically and periodontally healthy subjects), Group GP: generalized periodontitis, Group CKD: subjects with CKD with good periodontal health, Group CKD + GP: subjects with both generalized periodontitis and CKD. Demographic variables and periodontal parameters were measured and recorded. Blood pressure measurements and a detailed history and renal parameters such as serum creatinine, eGFR, and fasting blood sugar were recorded. The red-complex bacteria (RCB) were assessed in the subgingival plaque samples of all four groups using RT-PCR. Older participants (above 50 years) showed worse periodontal scores in the CKD + GP group along with elevated isolated systolic blood pressure, higher serum creatinine, and fasting blood sugar. eGFR was significantly decreased compared to the other groups. Bacterial counts were higher in the GP + CKD group, suggesting that they may be at a higher risk for generalized periodontitis and chronic kidney disease. Isolated systolic blood pressure (ISBP) and RCB were significantly correlated with the renal and periodontal parameters. A log-linear relationship exists between periodontal disease, CKD, RCB, and isolated systolic hypertension levels.

Highlights

Clinical hypertension and impaired regulation of arterial blood pressure and are two major systemic conditions associated with inflammation and immune dysfunction [1,2]
On comparing demographic variables between the various groups, mean age was highest in the chronic kidney diseases (CKD) + generalized periodontitis (GP) groups, and the difference was statistically significant among the groups with p = 0.0001 (Table 2)
This study set out to examine the relationship between isolated systolic blood pressure, generalized periodontitis, and chronic kidney disease in correlation with demographic, periodontal variables, and renal parameters taking the confounding factors into account

Summary

Introduction

Clinical hypertension and impaired regulation of arterial blood pressure and are two major systemic conditions associated with inflammation and immune dysfunction [1,2]. It is a prevalent risk factor for cardiovascular disease and the progression of chronic kidney disease. Hypertension plays a key role in the development and progression of chronic kidney disease (CKD) It is a major complication for uncontrolled hypertension can act as both the cause and the effect [9]. This interaction between hypertension and CKD poses an increased risk for adverse cardiovascular and cerebrovascular events [9]. The factors involved in the pathogenic mechanism of CKD and hypertension include sodium dysregulation, alterations in the renin-angiotensin-aldosterone axis, and increased sympathetic nervous system activity [8,9]

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