Background: Hypertension is a worldwide public health problem. We sought to explore the interaction of oral health and smoking on hypertension, and periodontal disease and smoking on hypertension.
Methods: We included 21,800 participants aged ≧30 years from the National Health and Nutrition Examination Survey (NHANES) 2009-2018. Information of oral health and periodontal disease were self-reported. Blood pressure was taken by trained personnel and/or physicians at mobile testing center. Multiple logistic regression was used to estimate the association between smoking, oral health, periodontal disease, and the risk of hypertension. The effects of oral health and periodontal disease on hypertension under smoking status were analyzed by stratified and interaction analysis.
Results: A total of 21,800 participants were investigated, including 11,017 (50.54%) in hypertensive group and 10,783 (49.46%) in non-hypertensive group. Compared with the excellent/very good of oral health, the multivariable-adjusted OR of good, fair, and poor were 1.17 (95% CI, 1.05–1.30), 1.37 (95% CI, 1.22–1.54), and 1.61 (95% CI, 1.36-1.92) (p for trend < 0.001) for hypertension, respectively. Compared without periodontal disease group, the multivariable-adjusted OR of periodontal disease for hypertension was 1.28 (95% CI ,1.16-1.42) (p for trend < 0.001). Furthermore, the p-values for interactions between oral health and smoking or between periodontal disease and smoking were < 0.001.
Conclusions: An association between oral health and periodontal disease with the prevalence of hypertension was identified. There exists interactive effect of oral health and smoking, periodontal disease and smoking on hypertension in American population over 30 years of age and older.