{"id":"cb9ce069484d","type":"article","url":"https://hartvaat.nl/2019/11/01/causaal-verband-periodontitis-en-hypertensie-mendeliaanse-randomisatie-en-rct/","title":"Causaal verband periodontitis en hypertensie: Mendeliaanse randomisatie en RCT","title_en":"Causal association between periodontitis and hypertension: evidence from Mendelian randomization and a randomized controlled trial of non-surgical periodontal therapy.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehz646","source_url":"https://doi.org/10.1093/eurheartj/ehz646","authors":["Marta Czesnikiewicz-Guzik","Grzegorz Osmenda","Mateusz Siedlinski","Richard Nosalski","Piotr Pelka","Daniel Nowakowski","Grzegorz Wilk","Tomasz P Mikolajczyk","Agata Schramm-Luc","Aneta Furtak","Pawel Matusik","Joanna Koziol","Miroslaw Drozdz","Eva Munoz-Aguilera","Maciej Tomaszewski","Evangelos Evangelou","Mark Caulfield","Tomasz Grodzicki","Francesco D'Aiuto","Tomasz J Guzik"],"significance":6,"published":"2019-11-01","source_date":"2019-11-01","image":"","kennis":[],"congress":"","summary_en":"This study combining Mendelian randomization with a randomized trial provided evidence for a causal link between periodontitis and hypertension, supporting the role of chronic oral inflammation in blood pressure elevation.","created":"2026-07-03T10:28:14Z","updated":"2026-07-03T13:27:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die met Mendeliaanse randomisatie en een gerandomiseerde trial bewijs levert voor een causaal verband tussen periodontitis en hypertensie.","abstract_original":"AIMS: Inflammation is an important driver of hypertension. Periodontitis is a chronic inflammatory disease, which could provide a mechanism for pro-hypertensive immune activation, but evidence of a causal relationship in humans is scarce. We aimed to investigate the nature of the association between periodontitis and hypertension. METHODS AND RESULTS: We performed a two-sample Mendelian randomization analysis in the ∼750 000 UK-Biobank/International Consortium of Blood Pressure-Genome-Wide Association Studies participants using single nucleotide polymorphisms (SNPs) in SIGLEC5, DEFA1A3, MTND1P5, and LOC107984137 loci GWAS-linked to periodontitis, to ascertain their effect on blood pressure (BP) estimates. This demonstrated a significant relationship between periodontitis-linked SNPs and BP phenotypes. We then performed a randomized intervention trial on the effects of treatment of periodontitis on BP. One hundred and one hypertensive patients with moderate/severe periodontitis were randomized to intensive periodontal treatment (IPT; sub- and supragingival scaling/chlorhexidine; n = 50) or control periodontal treatment (CPT; supragingival scaling; n = 51) with mean ambulatory 24-h (ABPM) systolic BP (SBP) as primary outcome. Intensive periodontal treatment improved periodontal status at 2 months, compared to CPT. This was accompanied by a substantial reduction in mean SBP in IPT compared to the CPT (mean difference of -11.1 mmHg; 95% CI 6.5-15.8; P < 0.001). Systolic BP reduction was correlated to periodontal status improvement. Diastolic BP and endothelial function (flow-mediated dilatation) were also improved by IPT. These cardiovascular changes were accompanied by reductions in circulating IFN-γ and IL-6 as well as activated (CD38+) and immunosenescent (CD57+CD28null) CD8+T cells, previously implicated in hypertension. CONCLUSION: A causal relationship between periodontitis and BP was observed providing proof of concept for development of clinical trial in a large cohort of hypertensive patients. ClinicalTrials.gov: NCT02131922."}