Overview

The death rate from hypertension-related diseases (high blood pressure) in the United States increased nearly 11% between 2005 and 2015. Related conditions to hypertension include cardiovascular diseases (CVD), stroke, and chronic kidney diseases. In a survey conducted by Malamed of more than 2,700 dentists in North America, 14,000 potentially life-threatening emergencies occurred while patients were in their dental practice. Hypertension is linked to risk factors that fall into two categories: 1) risk factors that are outside the patient’s control, such as family history, age, gender, and race, and 2) risk factors that the patient can control, such as physical activity, heart-healthy diet, overweight or obesity, medications and supplements, drug and alcohol use.

Other variables such as tobacco, stress, and physiological conditions e.g. sleep apnea are additional risk factors that contribute to hypertension. Obesity is a global issue, with a direct link to sleep apnea and other systemic conditions e.g. diabetes, cardiovascular, and metabolic syndrome. Obese patients are at an increased risk for hypertension and coronary heart disease, the most common type of heart disease. New studies show obesity may also increase the chance of peripheral artery disease (PAD) e.g. arms, legs, and feet. PAD is not just a senior disease. Currently 6.8 million Americans ages 40 and older were diagnosed with peripheral artery disease. We also need to screen our young adult patients. The Centers for Disease Control (CDC) recently reported the prevalence of obesity in the U.S. was 18.5%, affecting 13.7 million children and adolescents. The CDC has also reported that children and adolescents have high blood pressure, with 4% of youth aged 12-19 years old diagnosed with hypertension and another 10% having elevated blood pressure (previously prehypertension). Recent research studies are suggesting a causal relationship between overweight young adults and heart problems and an increased risk of ischemic stroke in young adults.

Taking patient blood pressure measurements during dental examinations is critical to our patient’s overall health. A baseline blood pressure reading should be established and then monitored at future dental appointments by dental staff. It is important for medical and dental providers to tell our patients what their blood pressure readings are each time, so that they can keep track of differences themselves. The 2017 guidelines recommend taking on average, 2-3 blood pressure readings on at least two different occasions to provide baseline data on each patient. Factors that may affect the accuracy of blood pressure measurements include caffeine, recent physical activity, smoking, and stress to name a few. Screening for blood pressure by dental professionals has proven to be extremely effective since many patients with hypertension may be unaware of their condition, as hypertension can develop slowly over time.