The Effect of Chlorhexidine Mouthwash on Blood Pressure: A Systematic Review and Meta-Analysis

This study evaluated the effect of rinsing with a chlorhexidine containing mouthwash (CHX-MW) on blood pressure (BP), as compared to rinsing with a control MW or no MW, based on (randomised) controlled trials and observational studies in humans. PROSPERO CRD42020222495.

The PubMed-MEDLINE and COCHRANE-CENTRAL databases were searched to identify eligible studies that had been published as of December 2024. Studies evaluating the effect of CHX-MW on human BP were included. A descriptive analysis of the selected studies and a meta-analysis was performed.

Searching identified 100 unique studies; five studies fulfilled all inclusion criteria and could be analysed. The descriptive analysis demonstrated that both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly increased after the use of CHX-MW in two of the included studies. The meta-analysis (MA) showed no significant difference of means (DiffM) based on end scores between CHX-MW and controls for SBP (DiffM = 1.56, P=0.17; 95% CI [-0.67; 3.80]) and DBP (DiffM = -0.10, P=0.91; 95% CI [-1.99; 1.78]).

For patients to whom the use of CHX-MW has been recommended, there is a moderate level of confidence that any change in BP due to the use of the antiseptic MW is insignificant or very small. The clinical importance of this BP elevation is estimated to be negligible.