Murli Ki Tano Si Status ((BETTER)) Download
Yuko Willian
Characteristics of studies are presented in Table 1. Eighteen studies38,41,42,43,44,45,46,48,49,50,52,54,56,57,58,59,60,60 categorized blood pressure into hypertensive and normal according to global criteria62 while six studies39,40,47,51,53,55 used values of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and did not apply these categories. Four studies used self-reported information on hypertensive status42,50,54,60.
There are two possible cascades related to the association between tooth loss and hypertension. It is speculated that progression of periodontitis, a major cause of tooth loss, consequently results in hypertension. The mechanisms by which periodontitis elicits hypertension are complex and not fully elucidated. The major mechanism by which increased blood pressure occurs in patients with periodontitis is likely to be the spread of inflammation and secondary damage to the vascular endothelium63,64,65,66. Periodontal tissue covers a wide area of the oral cavity. The influence of local inflammation of periodontitis occurring in a large proportion of the oral cavity may significantly contribute to systemic inflammation mediated by C-reactive protein and main inflammatory cytokines such as tumor necrosis factor alpha, interleukin 1b and interleukin 667,68. Increases in nitrate-reducing bacteria, which are observed in patients with periodontitis may induce a reduction of nitric oxide, which may consequently lead to an increase in blood pressure69,70,71. It was also reported that an intervention of non-surgical periodontal treatment leads to an improvement of both periodontal status and hypertension72. Another reason is that tooth loss causes a decrease in masticatory function, thereby inducing obesity. There are two possible explanations for the association between mastication and obesity. One is that the eating habits of people with poor masticatory function, and decreased consumption of vegetables and fruits, and higher consumption of high energy food, tend to cause obesity compared to those with adequate mastication73,74,75,76. Another is that a reduction in chewing leads to a decrease in diet-induced thermogenesis and inactivation of neuronal histamine, which may consequently lead to obesity77,78,79.
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