ArticleJournal of internal medicine2021
Is systemic inflammation a missing link between periodontitis and hypertension? Results from two large population-based surveys.
Article in Journal of internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 74 citations in OpenAlex.
- The role of periodontitis in the development of atherosclerotic cardiovascular disease in participants with the components of metabolic syndrome: a systematic review and meta-analysis.Clinical oral investigations · 2024Pooled it
- Serum Albumin and Uric Acid Levels Among Hypertensive Patients in Northwest Ethiopia: A Comparative Cross-Sectional Study.Health science reports · 2026Article
- Association between Albumin-to-Globulin Ratio and Periodontitis: A Cross-Sectional and Mendelian Randomisation Analysis.Oral health & preventive dentistry · 2026Article
- Causal relationship between oral diseases and hypertension: a Mendelian randomization study.Experimental biology and medicine (Maywood, N.J.) · 2026Article
- Article
- The Systemic Link Between Oral Health and Cardiovascular Disease: Contemporary Evidence, Mechanisms, and Risk Factor Implications.Diseases (Basel, Switzerland) · 2025Review
- Associations of body roundness index and inflammatory marker with hypertension among children and adolescents: a cross-sectional study.Scientific reports · 2025Article
- Construction of a predictive model for the transition from irreversible pulpitis to periodontal-involved disease.Odontology · 2025Article
- Denture use and all-cause mortality risk in Chinese edentulous elderly: a follow-up study.Scientific reports · 2025Article
- Pro-Inflammatory Markers in Serum and Saliva in Periodontitis and Hypertension.Medicina (Kaunas, Lithuania) · 2025Article
- Association between the preoperative N-terminal pro-B-type natriuretic peptide and acute kidney injury in gastrointestinal surgery patients managed with enhanced recovery strategy: a retrospective cohort study.Perioperative medicine (London, England) · 2025Article
- Effect of age and systemic inflammation on the association between severity of periodontitis and blood pressure in periodontitis patients.BMC oral health · 2025Article
- Sensitization to common foods and early vascular aging: associations and the mitigating effects of health behaviors.BMC public health · 2025Article
- Triglyceride-glucose index and periodontitis: evidence from two population-based surveys.Frontiers in endocrinology · 2025Article
- Association between dietary multi-metal intake and the risk of diabetic retinopathy: a population-based study.Frontiers in nutrition · 2025Article
- Accelerated biological aging mediates the association between periodontal disease and cognitive function in older adults.Innovation in aging · 2025Article
- Review
- Tooth loss and mortality risk: the mediating role of hs-CRP in a Chinese cohort.Frontiers in oral health · 2025Article
- The Association Between Periodontitis and the Prevalence and Prognosis of Metabolic Syndrome.Journal of multidisciplinary healthcare · 2025Article
- Mediating role of systemic inflammation in the association between volatile organic compounds exposure and periodontitis: NHANES 2011-2014.BMC oral health · 2024Article
Corrections and comments
- Commented on by
Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe primary objective was to investigate the relationship between periodontitis and hypertension in two independent large surveys. The secondary objective was to ascertain whether systemic inflammation had a mediation effect in the association.
methodsThis cross-sectional study analysed representative samples of the US (n = 3460; NHANES 2009/10) and Korean (n = 4539; 2015 KNHANES VI-3) populations. The association between periodontitis (exposure), hypertension (outcome) and inflammatory markers [C-reactive protein (CRP) and white blood cell counts (WBC)] (mediators) was assessed using multivariate linear and logistic regression models and mediation analysis.
resultsParticipants with periodontitis were more likely to have hypertension (NHANES: OR = 1.3, 95% CI: 1.0-1.6, P = 0.025; KNHANES: OR = 1.2, 95% CI: 1.0-1.4, P = 0.041) and actual systolic blood pressure ≥ 140 mmHg (NHANES: OR = 1.6, 95% CI: 1.1-2.3, P < 0.001; KNHANES: OR = 1.3, 95% CI :1.0-1.6, P < 0.031) than those without the disease. These associations were independent of age, gender, BMI, education level, smoking, alcohol consumption, creatinine, physical activity, presence of other comorbidities and confirmed in participants not taking antihypertensive medications. Diagnosis of periodontitis was directly associated with WBC (in both surveys: NHANES: β ± SE = 0.3 ± 0.1, P < 0.004; KNHANES: β ± SE = 0.3 ± 0.1, P < 0.001) and with CRP levels (in one survey: NHANES: β ± SE = 0.1 ± 0.03, P < 0.007; KNHANES: β ± SE = 0.1 ± 0.04, P > 0.213). Mediation analyses confirmed that CRP acted as a mediator in the association between periodontitis and hypertension in both populations (mediated effect: NHANES: β ± SE = 0.010 ± 0.003, P < 0.001; KNHANES: β ± SE = 0.003 ± 0.001, P = 0.015). WBC acted as a mediator in the KNHANES (mediated effect: β ± SE = 0.004 ± 0.001, P = 0.004) whilst in the NHANES, its effect was dependent of CRP inclusion in the model (mediated effect WBC + CRP: β ± SE = 0.002 ± 0.001, P = 0.001).
conclusionsThese findings suggest that periodontitis is closely linked to hypertension and systemic inflammation is, in part, a mediator of this association.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.