Association of periodontitis with hypertension: An updated systematic review and meta-analysis

The aim of this study was to update the association between periodontitis and hypertension.

A comprehensive literature search was conducted in the MEDLINE/PubMed, Web of Science, Scopus and Google Scholar databases to evaluate the association between periodontitis and hypertension up until May 2025. All observational studies, including cross-sectional, case-control, and cohort studies, were included. Two researchers independently conducted the screening of studies, data extraction, and quality assessment. Heterogeneity between studies was assessed using the Q-test (chi-square) and the I-squared statistic. A random-effects model/ fixed-effect model was applied to pool the effect sizes. The subgroup meta-analysis between periodontitis and hypertension was performed based on periodontitis indices, including probing depth (PD), clinical attachment loss (CAL), and their combination.

Out of 2,145 studies identified in the initial search, 72 were included in the systematic review, and 60 were included in the meta-analysis. In random-effect meta-analysis, periodontitis increased significantly the odds of hypertension according to the PD index (OR: 1.33, 95% CI: 1.22-1.45)), the CAL index (OR: 1.62 (1.12-2.36)), and their combination (OR: 1.62 (1.29-2.03)). Moreover, the mean diastolic blood pressure was significantly higher in individuals with periodontitis than in those without periodontitis based on the PD-CAL index (MD: 5.40 (5.38-5.41)).

This study provided evidence of a significant association between periodontitis and hypertension. Incorporating regular periodontal evaluations into patient care may contribute to better hypertension management and potentially reduce the risk of developing hypertension.

The online version contains supplementary material available at 10.1007/s40200-026-01936-1.