Strengthening the link between gum infection and vascular disease, researchers have found that older women who have lost teeth may be more than three times as likely to develop hypertension as those with all their teeth intact.

However, the Japanese team remains unsure as to whether hypertension encourages tooth loss, or vice versa.

Previous studies have linked tooth loss to coronary heart disease, cerebrovascular disease, and peripheral arterial disease. One possible explanation for this is that the inflammation associated with periodontal disease may contribute to endothelial dysfunction, plaque formation, or reduce the beneficial effects of high-density lipoprotein.

Alternatively, missing teeth could affect diet and nutrient intake, and increase the risk of vascular diseases in this manner.

To determine whether hypertension could also play a role in linking the two conditions, Akira Taguchi (Hiroshima University Hospital) and colleagues studied 67 postmenopausal women with missing teeth (mean remaining teeth=22.2), and 31 without missing teeth (28 teeth).

They found that women with all their teeth intact had significantly lower diastolic blood pressure than those in whom teeth were missing (73.1 vs 78.9 mmHg, p=0.021), and also had lower systolic pressure, which registered as borderline statistically significant (121.6 vs 129.1 mmHg, p=0.058).

Tooth loss was not significantly associated with other traditional risk factors for vascular disease, including lipid profile, resting heart rate, or plasma ACE, angiotensin II, or renin levels. After adjusting for other risk factors, the odds ratio of having hypertension in subjects with missing teeth was 3.59.

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